Steven Tong Profile picture
Infectious diseases physician, clinical researcher with interests in genomics and Indigenous health, follower of Jesus

Apr 25, 2022, 9 tweets

@AchimKaasch about to present SABATO results at #ECCMID2022!

SABATO has been going on for quite a while now!

Question: is switching to oral therapy for low risk SAB possible?

Low risk: negative follow-up BC, no mestatistic infection, intravascular catheters removed, no prosthetic vascular material, not immunosuppressed

Benefits and risks:

Design:

Study meds:
Reasonable choices, but noting that trimethoprim-sulfa inferior to vanc in Paul et al study for MRSA.

CONSORT diagram:

Ended up with smallish numbers still - 108 in oral and 105 in IV arms.

Baseline characteristics:
Only 5% MRSA. Line related infections about 60%.

Results:

No difference between treatment arms.
Certainly no difference in per protocol populations which the presentation focussed on.
Wasn't clear in presentation what the pre-defined non-inferiority margin was. If 5% then in the ITT may not have been NI.

Have looked at the trial protocol. The NI margin was intially 5% but then in the updated protocol increased to 10%. So looks like it meets the NI margin of 10% in the ITT for the primary outcome of SAB related complication in 90d: 0.007 (-0.078 to 0.091).

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