RecruitingPhase 3NCT07253688

Adjunctive Rifampin for the Treatment of Prosthetic Valve Endocarditis Due to S. Aureus

Adjunctive Rifampin for the Treatment of Prosthetic Valve Endocarditis Due to S. Aureus (RIFA-SNAP)


Sponsor

Todd C. Lee MD MPH FIDSA

Enrollment

330 participants

Start Date

Nov 10, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

This is a sub-study of the S. aureus Network Adaptive Platform (SNAP) trial (NCT05137119) wherein we will evaluate whether not giving rifampin in patients with probable or definite prosthetic valve endocarditis due to S. aureus is non-inferior to giving rifampin.


Eligibility

Min Age: 18 Years

Inclusion Criteria2

  • Probable or definite prosthetic valve endocarditis involving the tricuspid, pulmonic, mitral and/or aortic valves by the 2023 Duke-ISCVID Criteria (including Cardiac PET evidence if applicable);
  • Patient or healthcare proxy provide informed consent.

Exclusion Criteria14

  • Death deemed imminent and inevitable within days or patient will be receiving palliative care and has prognosis \< 90 days according to the treating team;
  • Patient requires intensive care but has a do not resuscitate order precluding transfer;
  • Polymicrobial bacteremia (not including skin commensals or other recognized contaminant);
  • Organism tests as rifampin resistant;
  • History of hypersensitivity/anaphylaxis or severe adverse reaction to rifampin;
  • Category X or other important drug-drug interaction with rifampin which cannot be safely mitigated \[with as-needed consultation from experts from pharmacy and/or internal medicine/geriatrics for potential deprescribing\];
  • Child Pugh Class C cirrhosis;
  • Clinician deems rifampin to be mandatory;
  • Patient has already received \>3 days of rifampin at time of screening or \>10 days of total therapy
  • Pregnancy or breast feeding
  • Administrative exclusions:
  • No reliable means of outpatient contact (telephone/email/text);
  • Previously enrolled;
  • Prior S. aureus bacteremia within the preceding 180 days

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Interventions

DRUGRifampin

Patients will receive rifampin 900mg a day in 2-3 divided doses

OTHERNo rifampin

Subjects will be assigned to not receive adjunctive rifampin


Locations(1)

McGill University Health Centre (Royal Victoria Hospital and Montreal General Hospital)

Montreal, Quebec, Canada

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NCT07253688


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