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)
Todd C. Lee MD MPH FIDSA
330 participants
Nov 10, 2025
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
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
Patients will receive rifampin 900mg a day in 2-3 divided doses
Subjects will be assigned to not receive adjunctive rifampin
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07253688