Implementation of biomarker-guided decision-making for antibiotic use in critically ill people with sepsis
What are we doing?
In this study, we are working with the Manchester-based NIHR HealthTech Research Centre in Emergency and Acute Care to support the implementation of the ADAPT-Sepsis trial findings.
When a critically ill adult is hospitalised with suspected sepsis, they are given antibiotics. To decide how long antibiotics are prescribed for, health professionals can assess blood biomarkers called procalcitonin (PCT) and C-reactive protein (CRP). The ADAPT-Sepsis trial tested whether using these biomarkers to guide the duration of antibiotic use was effective and safe compared with standard approaches to clinical decision making.
ADAPT-Sepsis found that, compared with standard care, using PCT measurements can reduce the duration of antibiotics use in people with sepsis, without compromising their risk of mortality. Using CRP measures does not appear to reduce the duration of antibiotic delivery compared with standard care, and findings about the impact on patient mortality are inconclusive.
Why is this important?
Trying to reduce the unnecessary use of antibiotics is important because of the growing risk of anti-microbial resistance. The findings of the ADAPT-Sepsis trial are important because they suggest using PCT-guided decision can reduce antibiotic use. However, we do not know how widely this approach is used in the UK, thus whether the best treatment is provided to patients with sepsis.
How are we doing it?
To meet our main aim of helping to implement the findings of the ADAPT-Sepsis trial, we have:
- completed a rapid survey of UK practice, to identify a clear research-practice gap to address.
- drafted a rapid systematic review that brings together the ADAPT-Sepsis trial with other relevant evidence. This review ensures that decision-making is based on all relevant evidence.
We are also planning events to better understand barriers to implementation of these research findings to consider how wider adoption of the ADAPT-Sepsis trial findings can be supported
Resources
Who are we working with?
• NIHR HealthTech Research Centre in Emergency and Acute Care
More information
NIHR ARC-GM Programme Manager
Gill Rizzello
Gill.rizzello@manchester.ac.uk