PROcalcitonin to SHORTen Antibiotics Duration in PEDiatricICU Patients (ProShort-Ped) Trial

NCT ID: NCT01652404

Last Updated: 2012-07-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-03-31

Study Completion Date

2012-12-31

Brief Summary

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The purpose of this study is to give conclusive evidence on whether serial PCT (Procalcitonin) measurements can facilitate individual decision-making and shorten antibiotic treatment duration in patients with sepsis in the pediatric ICU (Intensive Care Unit).

Detailed Description

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In this study, the investigators aimed to design a multi-center trial addressing aforementioned flaws. The investigators will set stricter inclusion criteria, collect complete data on relapse or secondary infection, and include sufficient number of patients to show non-inferiority to conventional therapy by a delta margin of 10% \[11\]. The investigators aimed to give conclusive evidence on whether serial PCT measurements can facilitate individual decision-making and shorten antibiotic treatment duration in patients with sepsis in the pediatric ICU.

Conditions

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Sepsis

Keywords

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ICU sepsis antibiotic therapy procalcitonin

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Procalcitonin-guided treatment

The duration of antibiotics will be determined by the procalcitonin levels.

Group Type EXPERIMENTAL

Procalcitonin-guided treatment

Intervention Type BEHAVIORAL

The antibiotics duration will be determined by the serum procalcitonin level at day 5, 7 and 9.

Conventional treatment

The duration of antibiotics will be determined by the treating physician.

Group Type ACTIVE_COMPARATOR

Conventional treatment

Intervention Type BEHAVIORAL

The antibiotics duration will be determined by treating physician.

Interventions

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Procalcitonin-guided treatment

The antibiotics duration will be determined by the serum procalcitonin level at day 5, 7 and 9.

Intervention Type BEHAVIORAL

Conventional treatment

The antibiotics duration will be determined by treating physician.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

All patients with laboratory- or image-confirmed severe infection at admission or during stay in pediatric ICU will be eligible for inclusion.

\* Definition of laboratory- or image-confirmed severe infection:

* Two or more of four signs of inflammation:

* Temperature \>38.3℃ or \<36℃
* Heart rate \> 90 beats/min
* Respiratory rate \>20 breaths/min or PaCO2 (Arterial pressure of carbon dioxide) \< 32 mmHg
* WBC (White Blood Cell count) \> 12,000 cells/mm3, \<4000 cells/mm3, or \>5% band-form WBC
* Initial Procalcitonin \> 0.5 ng/mL
* Presence of either laboratory or image evidence of infection
* Laboratory evidence: Sign of inflammation in urine, CSF (Cerebrospinal Fluid), ascites, pleural effusion or local abscess
* Image evidence: Compatible findings on Chest X ray, ultrasound, CT (Computed Tomography), MR image (Magnetic Resonance Image)

Exclusion Criteria

* Age greater than 15 years or less than 1 month
* Known pregnancy
* Expected ICU stay less than 3 days
* Neutropenia: ANC (Absolute Neutrophil Count) \<500/mm3
* Specific infections for which long-term antibiotic treatment is strongly recommended:

* Lobar pneumonia or empyema
* Bacterial meningitis
* Osteomyelitis
* Infective endocarditis
* Local abscess
* Mediastinitin
Minimum Eligible Age

1 Month

Maximum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role collaborator

Hunan Children's Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Chien-Chang Lee, MD, MSc

Role: PRINCIPAL_INVESTIGATOR

National Taiwan University Hospital

Yi-Min Zhu, BSc

Role: STUDY_CHAIR

Hunan Children's Hospital

Locations

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Hunan Children's Hospital

Changsha, Hunan, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Chien-Chang Lee, MD, MSc

Role: CONTACT

Phone: 886972651951

Email: [email protected]

Yi-Min Zhu, BSc

Role: CONTACT

Phone: 073185356850

Email: [email protected]

Facility Contacts

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Yi-Min Zhu, BSc

Role: primary

References

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Michael M, Hodson EM, Craig JC, Martin S, Moyer VA. Short versus standard duration oral antibiotic therapy for acute urinary tract infection in children. Cochrane Database Syst Rev. 2003;(1):CD003966. doi: 10.1002/14651858.CD003966.

Reference Type BACKGROUND
PMID: 12535494 (View on PubMed)

Lee SL, Islam S, Cassidy LD, Abdullah F, Arca MJ; 2010 American Pediatric Surgical Association Outcomes and Clinical Trials Committee. Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review. J Pediatr Surg. 2010 Nov;45(11):2181-5. doi: 10.1016/j.jpedsurg.2010.06.038.

Reference Type BACKGROUND
PMID: 21034941 (View on PubMed)

Other Identifiers

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HN01

Identifier Type: -

Identifier Source: org_study_id