AzTrials
AzTrials

Staphylococcus Aureus Bloodstream Infections (BSI; Bacteremia)LIPSNCT06958835

Linezolid Plus Standard of Care

A study testing Linezolid 600 mg in people with Staphylococcus Aureus Bloodstream Infections (BSI; Bacteremia), run by University Hospital, Basel, Switzerland at 12 sites in Switzerland.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The aim of the study is to assess whether targeting virulence factors by administering linezolid in addition to standard antibiotic treatment improves outcomes in patients with Staphylococcus aureus bacteraemia. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Linezolid 600 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
606 participants
Where
12 sitesSwitzerland
Study dates
6 Oct 2025to Oct 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Staphylococcus aureus (S. aureus) grown from at least one blood culture
  • Hospitalised at a participating centre
  • ≥18 years old
  • Written informed consent or fulfilling criteria for an emergency exception from informed consent requirements

Who cannot join

  • Administration of the initial drug treatment not feasible within 72 hours since the collection of the first positive blood culture with S. aureus
  • Documented history of positive blood cultures for S. aureus occurring between 72 hours and 180 days prior to the eligibility assessment
  • Necrotising fasciitis
  • Currently receiving linezolid or clindamycin
  • Use of any monoamine oxidase A or B inhibitor within the last two weeks
  • Known hypersensitivity to linezolid or any other ingredients of the study drugs
Show all 13Show fewer
  • Current severe thrombocytopenia (i.e. <30 x 10^9/L)
  • Application of study drug not possible (per mouth or per gastric tube)
  • Currently breastfeeding
  • Local treating team believes that death is imminent and inevitable
  • Patient is receiving end of life care and antibiotic treatment is not considered appropriate
  • Local treating team believes that participation in the study is not in the best interest of the patient
  • Any indication that the patient is unwilling to participate in the study including an advance directive stating such unwillingness

Trial locations and contacts

12 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Richard Kühl, PD Dr. med. contact

+41 61 328 66 61

richardalexander.kuehl@usb.ch

Natalie Rose, PhD contact

+41 61 328 35 54

natalie.rose@usb.ch

12 sites in 1 country

Switzerland12 sites, 12 recruiting
  • Kantonsspital Aarau (KSA)

    Aarau, Canton of Aargau

    Anna Conen, PD Dr. med. MSc.

    Recruiting
  • St. Claraspital

    Basel, Canton of Basel-City

    Elisabeth Wehrle-Wieland, Dr. med.

    Recruiting
  • University Hospital Basel (USB)

    Basel, 4031

    Natalie Rose, PhD, +41 61 328 35 54, natalie.rose@usb.ch

    Richard Kühl, PD Dr. med.

    Recruiting
  • Inselspital Bern

    Bern, Canton of Bern

    Christine Thurnheer, PD Dr. med.

    Recruiting
  • Hôpital du Jura

    Delémont, Canton of Jura

    Michèle Birrer, Dre

    Recruiting
  • Hôpitaux universitaires de Genève (HUG)

    Geneva, Canton of Geneva

    Stephan Harbarth, Prof. Dr. med.

    Recruiting
  • Centre hospitalier universitaire vaudois (CHUV)

    Lausanne, Canton of Vaud

    Matthaios Papadimitriou-Olivgeris, PD Dr. med. PhD

    Recruiting
  • Ente Ospedaliero Cantonale (EOC)

    Lugano, Canton Ticino

    Marco Bongiovanni, PD Dr. med.

    Recruiting
  • HOCH Health Ostschweiz, Kantonsspital St.Gallen

    Sankt Gallen, Canton of St. Gallen

    Werner Albrich, Prof. Dr. med.

    Recruiting
  • Kantonsspital Winterthur (KSW)

    Winterthur, Canton of Zurich

    Urs Karrer, PD Dr. med.

    Recruiting
  • Stadtspital Zürich Triemli

    Zurich, Canton of Zurich

    Adrian Schibli, Dr. med.

    Recruiting
  • Universitätsspital Zürich (USZ)

    Zurich, Canton of Zurich

    Barbara Hasse, Prof. Dr. med.

    Recruiting

Other trials in Switzerland

About this study

Official title: Combination Antibiotic Treatment With Linezolid for Staphylococcus Aureus Bacteraemia: a Randomised Controlled Trial

The aim of the study is to assess whether targeting virulence factors by administering linezolid in addition to standard antibiotic treatment improves outcomes in patients with Staphylococcus aureus bacteraemia.

Read the detailed description

Staphylococcus aureus (S. aureus) is one of the deadliest bacterial pathogens, especially in high-income countries, and causes bloodstream infections (bacteraemia) in 20-30 per 100,000 people annually. Despite widely available antibiotic treatments, the 90-day mortality rate remains high at 20-30%, and complications such as organ damage, relapses, and long-term impairment affect many survivors. Existing treatments have failed to improve survival rates highlighting the urgent need for novel therapeutic strategies.

Virulence factors produced by S. aureus facilitate bacterial persistence and spread, and tissue damage. Preclinical research suggests that inhibiting the production of virulence factors may improve patient outcomes. While some clinical guidelines recommend this approach for toxin-mediated infections, randomized controlled trials (RCTs) evaluating this approach in S. aureus bacteraemia have not yet been conducted.

Linezolid, an antibiotic commonly used for pneumonia and complicated skin and soft-tissue infections, has shown strong inhibition of the expression of S. aureus virulence factors in preclinical studies. Studies in animal models demonstrated that linezolid, when combined with other antibiotics, enhances treatment efficacy and reduces bacterial toxin production. Observational studies suggest that early initiation of linezolid may lead to better patient outcomes, but no RCT has tested this approach in S. aureus bacteraemia.

This placebo-controlled trial will evaluate whether adding a 5-day course of linezolid to standard antibiotic therapy improves clinical outcomes in patients with S. aureus bacteraemia.

Being tested
Linezolid 600 mg, Placebo
Keywords
Virulence factors, Linezolid, Bloodstream Infection, Hierarchical composite endpoint, Staphylococcus aureus, Bacteremia, Bacteraemia, Methicillin-resistant Staphylococcus aureus (MRSA), Penicillin-susceptible Staphylococcus aureus (PSSA), Methicillin-susceptible Staphylococcus aureus (MSSA)
Medical subject headings
Bacteremia, Sepsis, Staphylococcal Infections, Toxemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Linezolid 600 mgDrug

    linezolid 600 mg tablets (twice a day for 5 days)

  • PlaceboDrug

    Placebo tablets (twice a day for 5 days)

Study groups in NCT06958835
Study groupRoleWhat they receive
LinezolidExperimental600mg twice a day for 5 days (in addition to the standard antibiotic treatment)
Receives: Drug: Linezolid 600 mg
PlaceboPlacebo comparatororal placebo tablets twice a day for 5 days (in addition to the standard antibiotic treatment)
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Desirability of Outcome Ranking (DOOR)

    The hierarchical composite endpoint DOOR will be calculated based on the following 4 criteria:

    1. Alive at 90 days
    2. Return to usual level of function by day 90
    3. None of the following complications: Microbiological or clinical failure leading to treatment change; Serious adverse reaction; Adverse event leading to study drug discontinuation
    4. Hospital length of stay

    The primary outcome will be expressed as the win ratio, i.e., the ratio of the number of times that participants in the intervention group have a lower DOOR compared to those in the control group.

    In this study, a pairwise comparison is used, i.e., every participant in the linezolid group is compared with every participant in the control group. When comparing two participants, the winner will be determined by the first component of the DOOR in which the two participants differ, the only exceptions being ties when both participants die or if they do not die but have the same length of hospitalisation.

    Measured: From randomisation (day 1) until day 90

Secondary outcomes (24)
  1. All-cause mortality

    Proportion of patients who died from any cause during the duration of the study.

    Measured: From randomisation (day 1) until day 90

  2. Time to death

    Measured: From randomisation (day 1) until day 90

  3. Level of function

    Proportion of participants back to their usual level of function prior to the infection.

    Measured: From randomisation (day 1) until day 90

  4. Number of participants with microbiological failure leading to treatment change

    Any positive sterile site culture with Staphylococcus aureus (S. aureus) between 14 and 90 days after randomisation that leads to a change in treatment. A sterile site means any site of the body where microorganisms are usually absent, i.e. below the outer and inner colonised surfaces of the skin and mucous membranes. Positive sterile sites cultures include deep visceral and musculoskeletal abscesses obtained in a sterile manner.

    Measured: From day 14 to day 90 (randomisation = day 1)

  5. Number of participants with early microbiological failure leading to treatment change

    Any positive sterile site culture with S. aureus between 5 and 13 days after randomisation that leads to a change in treatment. A sterile site means any site of the body where microorganisms are usually absent, i.e. below the outer and inner colonised surfaces of the skin and mucous membranes. Positive sterile sites cultures include deep visceral and musculoskeletal abscesses obtained in a sterile manner.

    Measured: From day 5 to day 13 (randomisation = day 1)

  6. Number of participants with clinical failure leading to treatment change

    Newly identified focus of S. aureus between 14 and 90 days after randomisation as determined by the site investigator (or delegated physician) that leads to a change in treatment. This can incorporate clinical, radiological, microbiological and pathological findings.

    Measured: From day 14 to day 90 (randomisation = day 1)

  7. Number of participants with early clinical failure leading to treatment change

    Newly identified focus of S. aureus between 5 and 13 days after randomisation as determined by the site investigator (or delegated physician) that leads to a change in treatment. This can incorporate clinical, radiological, microbiological and pathological findings.

    Measured: From day 5 to day 13 (randomisation = day 1)

  8. Hospital length of stay

    Duration of the index acute hospital stay from randomisation until the day of hospital discharge. Transfers to another acute care hospital for continuation of acute treatment will be included in the assessment of hospital length of stay. Days after transfer to rehabilitation centres or switch to outpatient parenteral ambulatory treatment will not be included in the acute hospital stay.

    Measured: From randomisation (day 1) until day 90

  9. Time to being discharged alive

    For participants who die during the hospitalisation, 90 days will be recorded.

    Measured: From randomisation (day 1) until day 90

  10. Days alive without being on the Intensive Care Unit (ICU)

    Number of days a participant is alive and not hospitalised in the Intensive Care Unit.

    Measured: From randomisation (day 1) until day 90

  11. Days alive without antibiotics

    Number of days a participant is alive and not on any antibiotics.

    Measured: From randomisation (day 1) until day 90

  12. Mental health

    Mental health assessed by patient-reported outcome using Short Form-36 (SF-36) questionnaire. The SF-36 questionnaire score ranges from 0 to 100, with higher scores indicating better health.

    Measured: At day 90 (randomisation = day 1)

  13. Physical health

    Physical health assessed by patient-reported outcome using SF-36 questionnaire. The SF-36 questionnaire score ranges from 0 to 100, with higher scores indicating better health.

    Measured: At day 90 (randomisation = day 1)

  14. Number of participants with persistent bacteraemia

    1. aureus-positive blood culture on day 5 (±1 day) after randomisation. If day 2 or day 3 blood cultures are negative and no subsequent blood cultures are performed, the day 5 blood culture is presumed to be negative.

    Measured: At day 5 (randomisation = day 1)

  15. Two or more systemic inflammatory response syndrome (SIRS) criteria fulfilled

    SIRS criteria:

    • Abnormal body temperature (<36°C or >38°C)
    • tachypnoea or mechanical ventilation (RR>20 breaths per minute)
    • tachycardia (HR >90 beats per minute in an adult
    • abnormal leukocyte count (from routine blood sampling on day 5 ±1 day, defined as >12.0 x 10^9/L or <4.0 x 10^9/L or >10% of immature (band) forms)

    Measured: At day 5 (randomisation = day 1)

  16. Change in C-reactive protein (CRP)

    Day 1 CRP means any blood CRP measurement taken on randomisation day 1 or the calendar day prior to randomisation. If there is more than one measurement, the value recorded is the one taken closest before randomisation.

    Measured: From randomisation (day 1) until day 5

  17. Development of new antibiotic drug resistance in Staphylococcus aureus

    Any new resistance absent in the S. aureus from the initial blood culture and detected in any S. aureus cultured after the start of the intervention.

    Measured: From randomisation (day 1) until day 90

  18. Adverse events leading to study drug discontinuation

    Any adverse event (irrespective of grade) leading to study drug discontinuation as documented by the treating physician.

    Measured: From randomisation (day 1) until day 5

  19. Serious adverse reactions until day 90

    Any serious adverse event will be reported to the study-site principal investigator, who then assesses whether there is a reasonable causal relationship with the investigational medicinal product.

    Measured: From randomisation (day 1) until day 90

  20. Clinical signs of serotonin toxicity

    Assessed using the Hunter Serotonin Toxicity Criteria.

    Measured: From randomisation (day 1) until day 7

  21. Laboratory signs of myelosuppression

    Laboratory confirmation of thrombocytopenia, anaemia, or leukopenia.

    Measured: From randomisation (day 1) until day 7

  22. Evidence of hyperlactatemia

    In case of clinical suspicion of hyperlactatemia, lactate levels will be measured and compared to specific laboratory-defined reference ranges. For increased lactate levels, the causality with the study treatment will be assessed.

    Measured: From randomisation (day 1) until day 7

  23. Acute kidney injury

    Assessed on day 5 and, if participant remains hospitalised, on day 14, using the Kidney Disease Improving Global Outcomes (KDIGO) definition.

    Measured: From randomisation until day 14

  24. Number of participants with Clostridioides difficile (C. difficile)-associated diarrhoea

    This means a stool submitted to a clinical laboratory has tested positive for C. difficile toxin or toxin gene.

    Measured: From randomisation (day 1) until day 90

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 May 2025
  2. Study start6 Oct 2025
  3. Primary completionOct 2028 (estimated)
  4. Study completionOct 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
606 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06958835
Sponsor's protocol ID
2025-00655; am23Khanna3
Other IDs
2025
Acronym
LIPS
Status last verified
Jul 2026
First submitted
1 Apr 2025
Last updated
13 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: After publication of the main results, the full dataset will be submitted to the Data Access Committee of the Faculty of Medicine (MF-DAC) at the University of Basel. Other researchers interested in using the study data may contact the independent MF-DAC of the University of Basel to request access.

Publications

  • Rose N, Bernasconi NS, Schumacher M, Werlen L, Buchel D, Weisser M, Vogt SB, Wehrle-Wieland E, Conen A, Thurnheer MC, Martin Y, Birrer M, Bongiovanni M, Albrich WC, Karrer U, Schibli A, Harbarth S, Papadimitriou-Olivgeris M, Briel M, Hasse B, Khanna N, Kuehl R, Speich B. Linezolid in addition to standard antibiotic treatment for Staphylococcus aureus bacteraemia: study protocol for a randomised, placebo-controlled trial. BMJ Open. 2026 Apr 20;16(4):e118509. doi: 10.1136/bmjopen-2026-118509.

    PubMed 42009378

Questions about this trial

What is this clinical trial studying?

A study testing Linezolid 600 mg in people with Staphylococcus Aureus Bloodstream Infections (BSI; Bacteremia), run by University Hospital, Basel, Switzerland at 12 sites in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 13 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Richard Kühl, PD Dr. med. (+41 61 328 66 61, richardalexander.kuehl@usb.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Desirability of Outcome Ranking (DOOR) (time frame: From randomisation (day 1) until day 90). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06958835, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jul 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in