A £1.5 million research programme funded by the National Institute for Health Research (NIHR) has seen experts from the University of Warwick’s Warwick Medical School and Salford Royal Hospital trial a method to safely reduce the length of time a patient with suspected sepsis needs to spend taking antibiotics.
Sepsis is caused by septicaemia, a bacterial infection which causes the body to produce a severe immune reaction. A form of blood poisoning, it can lead to septic shock, multiple organ failure and subsequent death. Sepsis is usually treated by administering antibiotics to the infected individual for at least 7-10 days. However, due to increased general use of antibiotics for various different bacterial infections, resistance to antibiotics is growing, and it is feared that infections that were once previously manageable with antibiotics will develop resistance and become untreatable.
There is no good quality evidence upon which a decision can be based regarding whether it is safe to stop administering antibiotics early to patients with suspected sepsis.
As of yet there is no good quality evidence upon which a decision can be based regarding whether it is safe to stop administering antibiotics early to patients with suspected sepsis. This means that patients are still taking antibiotics for at least 7-10 days, even if they appear to be getting better.
However, this new research hopes to change the situation. In collaboration with Warwick Medical School’s Clinical Trials Unit, the research is being led by Professor Paul Dark, consultant in Critical Care Medicine at Salford Royal Hospital, the University of Manchester’s professor of Critical Care Medicine and NIHR Specialty Lead in Critical Care. Two separate tests are being carried out, looking at biomarkers within the blood to determine whether antibiotic treatment needs to be continued or if it can be safely stopped. This is the largest ever trial conducted into this area.
The study aims to recruit over 2,700 patients suspected of having sepsis in 30 NHS hospitals…
The study looks at two different biomarkers in the blood- C-reactive protein, which is often used to monitor inflammatory conditions in the NHS, but not yet routinely for sepsis, and procalcitonin, a much newer test which is used as a marker for severe bacterial infection. Following its pilot phase, the study aims to recruit over 2,700 patients suspected of having sepsis in 30 NHS hospitals across the United Kingdom. Patients will be assigned to one of three groups – one group will have their C-reactive protein monitored each day, another group will have procalcitonin checked daily, and the final group will receive standard care (the control group). The length of time patients of the different groups remain on antibiotics and the size of the dose administered will be compared, alongside survival rates and the time taken for the patients to become well enough for discharge from hospital.
According to Professor Dark, “This is very important as the antibiotics we use for sepsis are the ones we should be preserving for the most serious infections, to protect the health of patients both now and in the future.” Hopefully this research will provide insight into improving the treatment of sepsis, without compromising the effectiveness of antibiotics.