HRC project grant awarded for BALANCE+: A Platform Trial for Gram-Negative Bloodstream Infections

Researchers aiming to enhance treatment approaches for bloodstream infections (BSIs) caused by Gram-negative (GN) bacteria (e.g., gut bacteria) have received a $1.4 million project grant from the Health Research Council (HRC). The funding will support 'BALANCE+', a randomized clinical trial designed to efficiently investigate several critical questions in GN-BSI management. The trial's goals include optimizing treatment strategies, minimizing antibiotic resistance, and improving outcomes for patients affected by GN-BSI.

Gram-negative bacteria are responsible for approximately 40% of bloodstream infections in New Zealand, with disproportionately higher rates of BSI among Māori and Pacific Peoples. “We hope that BALANCE+ will deliver high-quality clinical evidence to guide the best possible treatment for these infections” says Dr Susan Morpeth, lead New Zealand investigator of the BALANCE+ trial. “Antimicrobial resistance is a global public health threat. BALANCE+ is aiming to answer some key questions by using well-known methods for improving how antibiotics are used. This is important in GN-BSI, where we still don’t have enough research” adds Natasha Pool, an Antimicrobial Stewardship Pharmacist who is working on the project. As part of the trial, a patient-centred sub-study led by Bobbie-Jo Pene (Ngāi Tūhoe) will explore the priorities of patients and their whānau in relation to bloodstream infection clinical trials. “This important work has the potential to inform other HRC-funded infection research across New Zealand” says Bobbie.

The HRC announced funding for BALANCE+ as part of its 2025 Project and Programme grant rounds, awarding 37 grants with a combined value of $60.6 million. These grants aim to support investigator-lead research focused on improving health outcomes for New Zealanders, while also strengthening vital health research capability and expertise. “Our team - made up of clinicians from hospitals across the country - is incredibly appreciative of this support from the HRC” says Dr Morpeth.

The New Zealand BALANCE+ Team is hosted by Aotearoa Clinical Trials at Middlemore Hospital. Together with researchers from Australia, Israel, Colombia, and Canada, they are contributing to the global BALANCE+ trial, hosted by the Sunnybrook Research Institute in Canada.

For more information, please contact Aotearoa Clinical Trials; Email: info@aotearoatrials.nz