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Adjunctive Rifampicin to Reduce Early mortality from STaphylococcus aureus bacteraemia: a multi-centre, randomised, blinded, placebo controlled trial
Will taking rifampicin as an extra antibiotic help sick people with S. aureus blood infections?
What is this study about?

Staphylococcus aureus (or S. aureus) is a bug that can cause serious infections, including infections of the blood. Doctors use an antibiotic to cure S. aureus but sometimes the infection comes back and sometimes the antibiotic does not succeed.

We want to find out whether or not giving an extra antibiotic, called rifampicin, in addition to the standard antibiotic treatment, will help sick people with S. aureus blood infections.


Between December 2012 and October 2016 758 participants with an S.aureus blood infection were randomly assigned to either 14 days of rifampicin or placebo in addition to standard backbone antibiotic therapy, as chosen by the attending physician. Everyone was followed up for 12 weeks, with the clinical assessments in hospital on days 0, 3, 7, 10 and 14 and then once per week until either discharge or week 12 - whichever occurred first.

ARREST showed that adding rifampicin to a treatment regimen did not improve cure rates or reduce deaths. There was also no evidence of any differences between the groups in serious adverse events but more people in the rifampicin group had antibiotic or trial drug-modifying adverse events and 24 (6%) versus six (2%) had drug interactions.

The ARREST results were presented at the ECCMID conference in Vienna, April 2017 and published in the Lancet in Dec 2017. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32456-X/fulltext?code=lancet-site)

Several podcasts, an audio summary and infographic summarising the study and discussing the results have been developed for clinicians and patients and can be accessed from this page.

Audio Summary of ARREST results

NIHR have produced a 'Signal' summarising the ARREST results which you can read about here

Q&A session

Join the ARREST team on Twitter for an Q&A session on June 26th - 16:00-17:00

Who is included?

To join, ARREST participants had to be in hospital and have a blood infection which the doctor thought was caused by S. aureus.

Contact details

When is it taking place?

ARREST opened to recruitment in November 2012. Participants were followed up for 12 weeks. Recruitment closed on 28th October 2016 and follow-up was completed on 18th January 2017.

Where is it taking place?

ARREST took place in 29 hospitals in the UK.

Who is funding the study?

It is funded by the NIHR Health Technology Assessment (HTA) programme, UK.

Further information

Type of study:
Randomised trial
Study start date:
26 November 2012

Related Publications

Thwaites, G.E., Scarborough, M., Szubert, A., Nsutebu, E., Tilley, R., Greig, J., Wyllie, S.A., Wilson, P., Auckland, C., Cairns, J., Ward, D., Lal, P., Guleri, A., Jenkins, N., Sutton, J., Wiselka, M., Armando, G.R., Graham, C., Chadwick, P.R., Barlow, G., Gordon, N.C., Young, B., Meisner, S., McWhinney, P., Price, D.A., Harvey, D., Nayar, D., Jeyaratnam, D., Planche, T., Minton, J., Hudson, F., Hopkins, S., Williams, J., Torok, M.E., Llewelyn, M.J., Edgeworth, J.D., Walker, A.S., on behalf of the United Kingdom Clinical Infection Research Group (UKCIRG.

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2018; 391:668-678

Thwaites, G., Auckland, C., Barlow, G., Cunningham, R., Davies, G., Edgeworth, J., Greig, J., Hopkins, S., Jeyaratnam, D., Jenkins, N., Llewelyn, M., Meisner, S., Nsutebu, E., Planche, T., Read, R.C., Scarborough, M., Soares, M., Tilley, R., Torok, M.E., Williams, J., Wilson, P., Wyllie, S., Walker, A.

Adjunctive rifampicin to reduce early mortality from staphylococcus aureus bacteraemia (ARREST): study protocol for a randomised controlled trial. Trials. 2012; 13:241-241

Marina, N., Bielack, S., Whelan, J., Smeland, S., Krailo, M, Sydes, M.R., Butterfass-Bahloul, T., Calaminus, G., Bernstein, .

International collaboration is feasible in trials for rare conditions: The EURAMOS Experience. Cancer Treatment and Research. 2010; 152:339-353

Marina, N., Bielack, S., Sydes, M.R., Bernstein, M., Butterfass-Bahloul, Smeland, S., Holliday, A., Whelan, .

International collaboration is feasible in trials for rare conditions: the EURAMOS experience. Journal of Clinical Oncology. 2007; 25:726S, 20501-726S, 20501