Managed Recovery Programme
ADAPT-Sepsis is now part of the Managed Recovery Programme as it has been identified as an important high priority critical care study for sites to deliver. This programme ensures targeted support from the CRN in collaboration with R&D departments is available to help sites recruit and open to the trial. If you are a site requiring further support to assist with capacity challenges or anything else, please get in touch with the ADAPT-Sepsis team to discuss this further.
To read more about the programme please click here.
The ADAPT-Sepsis team thanks all who supported the study through the challenge of COVID-19 and the trial's NIHR Urgent Public Health (UPH) badging.
Professor Dark discusses the lack of evidence surrounding procalcitonin testing for diagnosing and monitoring sepsis and CRP monitoring. He outlines the ADAPT-Sepsis trial, it's relevance in COVID-19 and outcomes.
BiomArker-guided Duration of Antibiotic treatment in hospitalised PaTients with suspected Sepsis: the ADAPT-Sepsis Trial
Chief Investigator: Professor Paul Dark
Sponsor: University of Manchester
Funder: Commissioned by NIHR Health Technology Assessment Programme
Registration Number: ISRCTN47473244
Sepsis is a common life-threatening condition that is triggered by infection. In sepsis, the body’s defence mechanisms (immune system) react excessively, resulting in widespread inflammation and swelling. If not treated quickly, sepsis can result in shutdown of vital organs which can result in death. Each year in the UK, about 200,000 people develop sepsis and up to a quarter will die. Previous research indicates that early recognition of sepsis and rapid antibiotic treatments are the most important factors for patient survival. While starting antibiotics for sepsis is crucial, the recommended duration of such treatment is uncertain. The lack of research on when to stop treatment safely can lead to an overuse of antibiotics in this condition. Antibiotic overuse is important because it promotes bacteria that are resistant to antibiotics (antimicrobial resistance), which means that sepsis and, indeed, other infections would become difficult to treat in the future. Shorter courses of antibiotics for a patient with sepsis, if given appropriately, may result in less antibiotic use resulting in fewer side effects, less risk of antibiotic resistance and a reduction in costs. Chemicals circulating in the blood can indicate the level of an infection and how effective the treatment of an infection is. These chemicals are called biomarkers. The two most well researched circulating biomarkers in sepsis are C-reactive protein (CRP) and procalcitonin (PCT). They are both protein chemicals produced by the human body in response to infection and can be readily measured in blood samples using NHS laboratory equipment. The aim of this study is to find out whether the duration of antibiotic treatment given to patients with sepsis can be safely reduced following the close daily monitoring of these biomarkers. Patients will have blood samples taken daily whilst receiving antibiotic treatment (typically 7 days), follow-up at 28 & 90 days.
2760 - patients will be randomised across the 3 arms using a ratio of 1:1:1
The primary objective of this trial is to determine whether treatment protocols based on monitoring CRP or PCT in hospitalised adult patients with suspected sepsis reduces the duration of antibiotic therapy (superiority) while maintaining treatment safety (non-inferiority) as measured by 28-day mortality.
4 years including follow-up