Can stable patients with uncomplicated Staphylococcus aureus bacteremia finish therapy by mouth? The SABATO trial tested early oral switch versus full-course IV therapy.

In this episode, we decode the SABATO trial - a randomized, open-label, non-inferiority study that compared continued intravenous (IV) antibiotics with an early oral switch in low-risk Staphylococcus aureus bacteremia (SAB).

Guest: Dr. Jen Ross, PharmD, BCIDP — Clinical Infectious Diseases Pharmacist at M Health Fairview

Study at a glance

• Design: Multicenter, randomized, open-label, non-inferiority trial
• Population: 213 adults with uncomplicated S. aureus bacteremia after > 5-7 days of IV therapy and no signs of complicated infection
• Intervention: Early oral switch (e.g., TMP-SMX, clindamycin, linezolid)
• Comparator: Continued full-course IV therapy
• Primary endpoint: SAB-related complications within 90 days
• Results: Primary outcome occurred in 13% of patients in oral group vs 12% in IV group which met non-inferiority criteria
• KEY Caveats: Did not include patients with IV drug use; stopped study early which can skew towards a significant finding; changed NI margin midway through which leads to accepting a wider risk of difference.
• Tune in to hear our perspectives on what this study is worth!?

Citation: Kaasch AJ et al. Early Oral Switch vs Continued IV Therapy for Low-Risk Staphylococcus aureus Bacteremia (SABATO Trial). Lancet Infect Dis. 2024; 24(3): 310-320. DOI 10.1016/S1473-3099(24)00032-X.

🎧 If you find this breakdown helpful, follow and leave a quick rating—it helps other clinicians and learners find high-quality, evidence-based content.

🎧 Email me at [email protected] if you have an article suggestion for me to decode!