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Staphylococcus aureus bacteremia is a common serious infection, yet limited data inform treatment choices. To test the hypothesis that adjunctive rifampicin would improve outcomes by enhancing early Staphylococcus aureus killing and reducing risk for metastatic infection, investigators conducted a double-blind, placebo-controlled trial. They randomly assigned adults (1:1) with S. aureus bacteremia who had received <96 hours of antibiotic treatment to 2 weeks of adjunctive rifampicin (oral or intravenous) or placebo. All participants also continued with standard antibiotic treatment, usually flucloxacillin (82%).
Among the 758 participants recruited from 29 U.K. hospitals, 64% had community-acquired S. aureus infections and 17% had nosocomial…