Status:

RECRUITING

Integrated Clinical Decision Support for Empiric Antibiotic Selection in Sepsis

Lead Sponsor:

Ottawa Hospital Research Institute

Collaborating Sponsors:

Canadian Institutes of Health Research (CIHR)

Conditions:

Sepsis

Bacterial Infections

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

As antibiotic resistance increases globally, it becomes more difficult to select empiric antibiotic therapy, particularly in patients with sepsis who stand to benefit from early adequate treatment. In...

Eligibility Criteria

Inclusion

  • Inclusion Criteria:
  • Admitted
  • Age \>18 years old
  • Newly started (within 24 hours of assessment for eligibility) on at least one of the following antibiotic(s):
  • I. Vancomycin IV II. Linezolid III. Daptomycin IV. Clindamycin V. Cefazolin VI. Cloxacillin VII. Ceftriaxone VIII. Ceftazidime IX. Piperacillin-Tazobactam X. Meropenem (or Imipenem or Ertapenem) XI. Ciprofloxacin
  • Blood cultures ordered (within 12 hours before or after initiation of index antibiotics).
  • Overall Exclusion:
  • Pregnancy/breastfeeding
  • Documented end-of-life (palliative) care and are/will not be receiving ongoing antibiotic treatment.
  • Already enrolled in the trial.
  • Positive clinical culture results (those with speciation) for the index infection (within 72 hours) already available prior to assessment. Blood cultures with any Gram-positives will be an exclusion. Other cultures that are positive with a Gram-stain result but not speciation will not be an exclusion criteria.
  • Explanatory molecular test (e.g. legionella urinary antigen test, sars-cov-2 testing) within 72 hours prior to assessment.
  • Receipt of antimicrobials (not chronic suppression or prophylaxis) in the prior 24-72 hours (except if started in the outpatient setting or ED prior to admission in the 24-72 hours).
  • The index prescription is a continuation of an antibiotic given for suppressive chronic therapy or long-standing treatment of an established infection.
  • Index antibiotics are peri-operative only or ordered for \<24 hours.
  • Cystic fibrosis.
  • Known to be enrolled in a trial that dictates antimicrobial selection.
  • Not eligible for any of the algorithms.

Exclusion

    Key Trial Info

    Start Date :

    May 21 2024

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    October 1 2025

    Estimated Enrollment :

    1440 Patients enrolled

    Trial Details

    Trial ID

    NCT06103500

    Start Date

    May 21 2024

    End Date

    October 1 2025

    Last Update

    March 17 2025

    Active Locations (3)

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    Page 1 of 1 (3 locations)

    1

    Trillium Health Partners

    Mississauga, Ontario, Canada

    2

    The Ottawa Hospital

    Ottawa, Ontario, Canada

    3

    Sunnybrook Health Sciences Centre

    Toronto, Ontario, Canada