Timing of S. aureus-related mortality in a large randomized clinical trial: Implications for future study design

The study analyzed the timing and relatedness of 247 deaths in a large clinical trial (SNAP) involving 1515 adult patients with S. aureus bacteremia from 37 Canadian hospitals. Using blinded duplicate adjudication, researchers found that 97 deaths (39.3%) were at least possibly related to the infection and 150 deaths (60.7%) were unrelated. Median survival was significantly shorter in patients with infection-related deaths (12 days versus 30.5 days). Approximately 80% of infection-related deaths occurred by day 30, whereas 50% of unrelated deaths occurred between days 30 and 90. The authors recommend that future studies evaluating acute S. aureus therapies should use a 30-day all-cause mortality window instead of 90 days, as later deaths are predominantly unrelated to the infection.