ADAPT-Sepsis

Biomarker-guided duration of antibiotic treatment in hospitalised patients with suspected sepsis

PICO Question

  • Population: ICU patients who have started IV antibiotics for sepsis

  • Interventions: CRP or PCT guided recommendations regarding cessation of antibiotics

  • Comparison: Usual care

  • Outcomes: Duration of antibiotic use and 28-day mortality

Recruitment

Inclusion criteria

Exclusion criteria

  • ≥18 years old

  • ≤24 hours of empiric IV antibiotics** for suspected sepsis*

  • Likely to remain on IV antibiotics for >72 hours Requirement for critical care

  • >24 hours since first empiric IV antibiotics for suspicion of sepsis

  • >21 days antimicrobial therapy required (e.g. endocarditis, TB, osteomyelitis)

  • Severely immunocompromised (e.g. neutropenia not caused by sepsis)

  • All treatments for suspected sepsis likely to be stopped <24 hours for futility

  • Given, or anticipated to receive, an IL-6 receptor inhibitor

  • Consent declined

  • Previously enrolled in this trial.

*Suspected sepsis definition: ‘acute organ dysfunction associated with suspected infection’ (Sepsis-3) **Note that this can include escalation of antibiotics - so someone who's been on co-amox on the ward for a CAP, and is being escalated to Tazocin for sepsis, might count

Details

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