From random care to randomized clinical trials of patients with invasive streptococcal infections—research prioritisation and areas of equipoise

Life-threatening invasive infections caused by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis (SDSE) are unpredictable, frequently fatal, and are increasing in incidence globally. In the absence of evidence from randomized controlled trials (RCTs), clinical management for these conditions varies. Understanding current management approaches and areas of clinical equipoise will inform planning of feasible high-impact RCTs.

Citation:
Tavlian S, Osowicki J, Xie O, Marks M, ……. Bowen AC, Davis JS, Tong SYC, Gibney KB. From random care to randomized clinical trials of patients with invasive streptococcal infections—research prioritisation and areas of equipoise. CMI Communications. 2025;2(4):105137.

Keywords:
Bacteraemia; Equipoise; Randomized controlled trial; Research prioritisation; streptococci

Abstract:
Life-threatening invasive infections caused by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis (SDSE) are unpredictable, frequently fatal, and are increasing in incidence globally. In the absence of evidence from randomized controlled trials (RCTs), clinical management for these conditions varies. Understanding current management approaches and areas of clinical equipoise will inform planning of feasible high-impact RCTs.