Therapeutic Drug Monitoring and Continuous Infusion of Beta-lactam Antibiotics in Patients With Bacteraemia
Primary Purpose
Bacteremia
Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Continuous infusion of beta-lactam antibiotics .
Therapeutic drug monitoring of beta-lactam antibiotics.
Sponsored by
About this trial
This is an interventional treatment trial for Bacteremia focused on measuring Therapeutic drug monitoring, Continuous infusion, Beta-lactam, Antibiotics, Bacteraemia
Eligibility Criteria
Inclusion Criteria:
- Have a positive blood culture.
- Undergo treatment with either intravenous penicillin, ampicillin, piperacillin/tazobactam, dicloxacillin, cefuroxime or meropenem.
- Hospitalised at Hvidovre University Hospital.
- Age ≥ 18.
- Able to understand and give informed consent.
- Included in the study within 24 hours after the final positive blood culture answer.
Exclusion Criteria:
- Positive blood culture is interpreted as contamination.
- The patient dies before the intervention.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
TDM and CI.
Control
Arm Description
Continuous infusion of beta-lactam antibiotics. Therapeutic drug monitoring of beta-lactam antibiotics.
Beta-lactam antibiotics given as intermittent infusion. Samples of serum concentration of beta-lactam will be collected for comparison, but blinded during the study.
Outcomes
Primary Outcome Measures
Target concentrations.
Serum concentrations within the target values for intervention. Following beta-lactams is included in the study: Benzylpenicillin, ampicillin, dicloxacillin, piperacillin/tazobactam, cefuroxime and meropenem.
Secondary Outcome Measures
Morbidity.
Diagnoses compared between the two arms.
Number of days until medically discharged.
Number of days until medically discharged compared between the two arms.
Failed antibiotic treatments.
Adding an additional antibiotic and/or change to a different antibiotic (not including a more narrow spectrum antibiotic) compared between the two arms.
Amount of antibiotic used.
Defined daly doses of antibiotic therapy compared between the two arms.
Antibiotic side effects and complications.
The severity of bacteraemia, mechanical ventilation and start-up of dialysis compared between the two arms. Growth of antibiotic-associated pathogenic in patient material compared between the two arms.
Mortality.
30-day mortality compared between the two arms.
Number of participants with abnormal clinical data and/or abnormal laboratory values.
Clinical data includes height, weight, heart rate, blood pressure, respiratory rate, Glasgow Coma Scale score, body temperature, fous of infection, the severity of bacteraemia, dialysis and laboratory values includes hemoglobin, white blood cells, neutrophils, thrombocytes, C-reactive protein, sodium, potassium, creatinine, albumin, lactate dehydrogenase, alanine amino transferase and lactate. Both will be compared between the two arms.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03108690
Brief Title
Therapeutic Drug Monitoring and Continuous Infusion of Beta-lactam Antibiotics in Patients With Bacteraemia
Official Title
Therapeutic Drug Monitoring and Continuous Infusion of Beta-lactam Antibiotics in Patients With Bacteraemia
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Logistics
Study Start Date
October 1, 2017 (Anticipated)
Primary Completion Date
March 9, 2023 (Actual)
Study Completion Date
March 9, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Sara Thønnings
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
5. Study Description
Brief Summary
The study investigates whether Therapeutic Drug Monitoring (TDM) and continuous infusion (CI) of beta-lactam antibiotics optimises target concentrations in patients with bacteraemia.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bacteremia
Keywords
Therapeutic drug monitoring, Continuous infusion, Beta-lactam, Antibiotics, Bacteraemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Factorial Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
TDM and CI.
Arm Type
Experimental
Arm Description
Continuous infusion of beta-lactam antibiotics. Therapeutic drug monitoring of beta-lactam antibiotics.
Arm Title
Control
Arm Type
No Intervention
Arm Description
Beta-lactam antibiotics given as intermittent infusion. Samples of serum concentration of beta-lactam will be collected for comparison, but blinded during the study.
Intervention Type
Drug
Intervention Name(s)
Continuous infusion of beta-lactam antibiotics .
Other Intervention Name(s)
Benzylpenicillin, Ampicillin, Dicloxacillin, Piperacillin/tazobactam, Cefuroxime, Meropenem
Intervention Description
Beta-lactam antibiotic will be administered as continous infusion.
Intervention Type
Other
Intervention Name(s)
Therapeutic drug monitoring of beta-lactam antibiotics.
Intervention Description
Dosage of beta-lactam antibiotics will be adjusted according to serum concentration.
Primary Outcome Measure Information:
Title
Target concentrations.
Description
Serum concentrations within the target values for intervention. Following beta-lactams is included in the study: Benzylpenicillin, ampicillin, dicloxacillin, piperacillin/tazobactam, cefuroxime and meropenem.
Time Frame
30 days after intervention.
Secondary Outcome Measure Information:
Title
Morbidity.
Description
Diagnoses compared between the two arms.
Time Frame
30 days after intervention.
Title
Number of days until medically discharged.
Description
Number of days until medically discharged compared between the two arms.
Time Frame
30 days after intervention.
Title
Failed antibiotic treatments.
Description
Adding an additional antibiotic and/or change to a different antibiotic (not including a more narrow spectrum antibiotic) compared between the two arms.
Time Frame
30 days after intervention.
Title
Amount of antibiotic used.
Description
Defined daly doses of antibiotic therapy compared between the two arms.
Time Frame
30 days after intervention.
Title
Antibiotic side effects and complications.
Description
The severity of bacteraemia, mechanical ventilation and start-up of dialysis compared between the two arms. Growth of antibiotic-associated pathogenic in patient material compared between the two arms.
Time Frame
30 days after intervention.
Title
Mortality.
Description
30-day mortality compared between the two arms.
Time Frame
30 days after intervention.
Title
Number of participants with abnormal clinical data and/or abnormal laboratory values.
Description
Clinical data includes height, weight, heart rate, blood pressure, respiratory rate, Glasgow Coma Scale score, body temperature, fous of infection, the severity of bacteraemia, dialysis and laboratory values includes hemoglobin, white blood cells, neutrophils, thrombocytes, C-reactive protein, sodium, potassium, creatinine, albumin, lactate dehydrogenase, alanine amino transferase and lactate. Both will be compared between the two arms.
Time Frame
30 days after intervention.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Have a positive blood culture.
Undergo treatment with either intravenous penicillin, ampicillin, piperacillin/tazobactam, dicloxacillin, cefuroxime or meropenem.
Hospitalised at Hvidovre University Hospital.
Age ≥ 18.
Able to understand and give informed consent.
Included in the study within 24 hours after the final positive blood culture answer.
Exclusion Criteria:
Positive blood culture is interpreted as contamination.
The patient dies before the intervention.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sara Thønnings, MD
Organizational Affiliation
Hvidovre University Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Therapeutic Drug Monitoring and Continuous Infusion of Beta-lactam Antibiotics in Patients With Bacteraemia
We'll reach out to this number within 24 hrs