A new international trial has received $5 million in federal funding from the Medical Research Future Fund (MRFF) to improve treatment for life-threatening streptococcal infections. 

Spearheaded by leading researchers and clinicians from the Doherty Institute and Murdoch Children's Research Institute (MCRI), the STRAP trial will explore the most effective treatments for severe forms of the infections, in both children and adults, caused by Strep A and Strep C/G bacteria. 

Strep A infections can result in mild throat infections to scarlet fever and rheumatic fever while Strep A and Strep C/G infections can lead to sepsis, necrotising fasciitis and toxic shock syndrome. 

Australia recorded almost 3,000 cases of invasive Strep A in 2023, more than doubling the rate of previous years. In children, particularly those under five or with underlying conditions, invasive Strep A can progress rapidly and lead to severe complications.

First Nations people are disproportionately affected by invasive Strep A and Strep C/G, with rates up to ten times higher than those of non-Indigenous Australians.

The Royal Melbourne Hospital’s Associate Professor Katherine Gibney, an infectious diseases physician based at the Doherty Institute and Chief Investigator, who welcomed the funding, said STRAP would test several combinations of treatments to identify those that genuinely help patients recover and which may be ineffective or even harmful. 

“While penicillin remains the mainstay of treatment for invasive infections with Strep A or Strep C/G, many doctors also prescribe additional medications like ceftriaxone, clindamycin, linezolid, or an expensive blood product known as intravenous immunoglobulin,” she said. But there’s currently little solid evidence to show which combinations of these treatments work best.”

“This trial aims to change that. For the first time, we’ll have clear, high-quality evidence to guide the treatment of these deadly infections. This will help clinicians make informed decisions, save lives and avoid unnecessary or harmful interventions.” 

MCRI Dr Joshua Osowicki, Co-Chief Investigator, said clinicians were currently relying on what they believed to be best practice without clear data. 

Image: Dr Joshua Osowicki 

"In recent years, paediatric hospitals around the world have been treating an unusually high number of children with life-threatening streptococcal infections,” he said. 

“Our study will provide the answers clinicians need to better treat children with streptococcal infections and improve their quality of life.” 

The grant will also support the trial’s next phase, including finalising the study design, securing ethics approvals and starting patient recruitment in Australian hospitals in 2026. Over the next four years, STRAP aims to enrol more than 2,000 participants across Australia, Canada, New Zealand and the UK. 

STRAP builds on the foundation of the successful Staphylococcus aureus bacteraemia Network Adaptive Platform Trial (SNAP) trial, which brought together over 100 hospitals across eight countries. 

Crucially, STRAP has been co-designed with patients and communities. A Consumer Reference Group has already helped shape the trial to ensure it reflects the priorities and lived experiences of patients and their families. 

Read more about our new Strep A bacteria discovery and grant that are helping to accelerate the development of a Strep A vaccine.

Funding: This research is supported by a Medical Research Future Fund Clinical Trial Activity Grant (MRF2035666).