Screening Anti-Fungal Exposure in Intensive Care Units

NCT ID: NCT03136926

Last Updated: 2018-06-21

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

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-01-31

Study Completion Date

2018-12-31

Brief Summary

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Adequate antifungal therapy is a critical determinant of survival in patients admitted to an Intensive Care Unit (ICU) with suspected or proven fungal infections. Critical illness can alter the way human body handles antifungal agents, i.e. how the drugs are distributed in the body and removed from the body. Consequently, these changes can increase the risk of inappropriate antifungal exposure that may lead to adverse consequence on patients' outcome. Developing an evidence-based antifungal dosing guideline is of global significance and should be considered a priority to improving clinical outcomes for patients receiving antifungal agents

The aim of the SAFE-ICU Study is to develop optimised antibiotic dosing guidelines for ICU patients with life-threatening infections that account for patient characteristics. This will be achieved through completion of the following aims:

i) Describe detailed demographic, clinical and plasma antibiotic concentration-time data in a large ICU patient cohort; ii) Perform a robust statistical analysis of the data collected in Aim 1 to develop an enhanced preliminary prediction algorithm for antifungal dosing.

This is a multi-national study and will enrol ICU patients who are prescribed an antifungal agent (fluconazole, voriconazole, posaconazole, isavuconazole, caspofungin, anidulafungin, micafungin or amphotericin B). A minimum of 12 patients per drug will be enrolled across at least 15 countries and up to 80 ICUs.

Eligible patients are those admitted to the ICU, who are prescribed an antifungal agent (fluconazole, voriconazole, posaconazole, isavuconazole, caspofungin, anidulafungin, micafungin or amphotericin B). Blood samples will be taken to measure drug concentration. Sampling will occur on two occasions, first during study days 1-3 and then a second time between days 4-7, each over an 8-24 hour period. Blood samples will be taken from a vascular access device already inserted for ICU patient care. Abdominal samples from abdominal indwelling drains already inserted peri operatively will also be collected on these two occasions in the subgroup of patients with intra-abdominal infection. Data on infection, various blood tests and patient specific data will be collected using a structured case report form (CRF). Patients will also be followed up 30 days after enrolment into the study to evaluate 30-day mortality.

Collected samples will be frozen and stored locally and then shipped in large batches for processing at Burns Trauma and Critical Care Research Centre, The University of Queensland, Australia. Data analysis for development of antifungal dosing algorithms will also be undertaken at The University of Queensland, Australia.

Detailed Description

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Conditions

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Antifungal Agents

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18
* Critically ill patients requiring ICU care
* Receiving enteral or intravenous therapy of antifungal of interest (triazole, echinocandin, amphotericin) including prophylaxis indication and antifungal therapy started in another unit (wards, operating room) for the same infectious episode
* Availability of suitable intravenous/intra-arterial access to facilitate sample collection
* Written informed consent has been obtained from the patient or their next of kin (according to local regulatory statements for ethical conduct of research at each study site)

Exclusion Criteria

* Aged \< 18 years of age
* Pregnancy
* Consent not obtained (according to local regulatory statements for ethical conduct of research at each study site)
* Diagnosis with human immunodeficiency virus or hepatitis B or C or tuberculosis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The University of Queensland

OTHER

Sponsor Role lead

Responsible Party

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Jason A Roberts

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jason A Roberts, PhD

Role: PRINCIPAL_INVESTIGATOR

The University of Queensland

Locations

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Oschner Medical Center

New Orleans, Louisiana, United States

Site Status NOT_YET_RECRUITING

Royal Brisbane and Women's Hospital

Brisbane, Queensland, Australia

Site Status RECRUITING

The Royal Melbourne Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Antwerp University Hospital

Edegem, Antwerp, Belgium

Site Status RECRUITING

Universitary Saint-Luc hospital

Brussels, Brussels Capital, Belgium

Site Status RECRUITING

Uz Brussel

Brussels, , Belgium

Site Status RECRUITING

Ghent University hospital

Ghent, , Belgium

Site Status RECRUITING

UZ Gasthuisberg

Leuven, , Belgium

Site Status RECRUITING

CHU de Charleroi site Marie Curie

Lodelinsart, , Belgium

Site Status RECRUITING

Chu Ambroise Pare

Mons, , Belgium

Site Status RECRUITING

Clinique Saint-Pierre

Ottignies, , Belgium

Site Status RECRUITING

The Health Sciences Center University of Manitoba

Winnipeg, Manitoba, Canada

Site Status NOT_YET_RECRUITING

Queen Elizabeth II Health Sciences Centre

Halifax, Nova Scotia, Canada

Site Status NOT_YET_RECRUITING

Helsinki University Central Hospital

Helsinki, , Finland

Site Status RECRUITING

North-Karelia Central Hospital

Joensuu, , Finland

Site Status RECRUITING

Kuopio University Hospital

Kuopio, , Finland

Site Status RECRUITING

Päijänne Tavastia Central Hospital

Lahti, , Finland

Site Status RECRUITING

Tampere University Hospital

Tampere, , Finland

Site Status RECRUITING

Turku University Hospital

Turku, , Finland

Site Status RECRUITING

CHRU de Nîmes - Hôpital Universitaire Carémeau

Nîmes, , France

Site Status NOT_YET_RECRUITING

APHP Hôpital Bichat - Réanimation médicale et Maladies infectieuses

Paris, , France

Site Status NOT_YET_RECRUITING

Chu de BORDEAUX Hôpital Haut-Leveque - Réanimation

Pessac, , France

Site Status NOT_YET_RECRUITING

CH Annecy Genevois - Réanimation

Pringy, , France

Site Status NOT_YET_RECRUITING

ATTIKON University Hospital

Athens, , Greece

Site Status RECRUITING

Prince of Wales Hospital

Hong Kong, Hong Kong SAR, Hong Kong

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Universitaria Pisana

Pisa, , Italy

Site Status NOT_YET_RECRUITING

Ospedale San Filippo Neri

Roma, , Italy

Site Status NOT_YET_RECRUITING

San Giovanni Addolorata Hospital

Roma, , Italy

Site Status NOT_YET_RECRUITING

Sapienza, Universita di roma

Rome, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino

Torino, , Italy

Site Status NOT_YET_RECRUITING

Hospital Sultan Ismail

Johor Bahru, Johor, Malaysia

Site Status NOT_YET_RECRUITING

Hospital Universiti Sains Malasysia

Kota Bharu, Kelantan, Malaysia

Site Status NOT_YET_RECRUITING

Hospital Tengku Ampuan Afzan

Kuantan, Pahang, Malaysia

Site Status RECRUITING

International Islamic University Malaysia Medical Center

Kuantan, Pahang, Malaysia

Site Status NOT_YET_RECRUITING

University Malaya Medical Centre

Kuala Lumpur, , Malaysia

Site Status NOT_YET_RECRUITING

Hospital Serdang

Serdang, , Malaysia

Site Status NOT_YET_RECRUITING

Radboud University Nijmegen Medical Centre

Nijmegen, , Netherlands

Site Status NOT_YET_RECRUITING

Centro Hospitalar Universitario de coimbra

Coimbra, , Portugal

Site Status RECRUITING

Hospital Geral

Coimbra, , Portugal

Site Status NOT_YET_RECRUITING

Hospital de Santa Maria

Lisbon, , Portugal

Site Status NOT_YET_RECRUITING

Hospital S. João

Porto, , Portugal

Site Status NOT_YET_RECRUITING

Instituto Português de Oncologia do Porto Francisco Gentil

Porto, , Portugal

Site Status RECRUITING

Hospital Vila Franca de Xira

Vila Franca de Xira, , Portugal

Site Status NOT_YET_RECRUITING

Hospital Del Mar

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitario Vall d'Hebron

Barcelona, , Spain

Site Status NOT_YET_RECRUITING

Hospital de Bellvitge

Barcelona, , Spain

Site Status NOT_YET_RECRUITING

Hospital Clínico Universitario de Valencia

Valencia, , Spain

Site Status NOT_YET_RECRUITING

Countries

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United States Australia Belgium Canada Finland France Greece Hong Kong Italy Malaysia Netherlands Portugal Spain

Central Contacts

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Fekade B Sime, PhD

Role: CONTACT

+61 412 181 027

Jason A Roberts, PhD

Role: CONTACT

+61 7 3365 5114

Facility Contacts

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Leonardo Seoane

Role: primary

Jason Roberts

Role: primary

+61 7 3646 4108

Monica Slavin

Role: primary

Jai Darvall

Role: backup

+61 3 9342 4120

Karolien Dams

Role: primary

'003238213635

Philippe Jorens

Role: backup

003238215175

Xavier Wittebole

Role: primary

+32 2 764 28 69

SPAPEN HERBERT

Role: primary

'32-3-4775117

Jan De Waele

Role: primary

+32 9 332 21 42

Joost Wauters, MD, PhD

Role: primary

(0032)16344275

Joosten Anne

Role: primary

003271923395

Cinderella Noel

Role: backup

003271923397

HAENTJENS LIONEL

Role: primary

003265413708

Nicolas De Schryver

Role: primary

+32 10 43 77 34

Anand Kumar

Role: primary

204-291-0372

Meghan MacKenzie

Role: primary

902-999-8110

Miia Valkonen

Role: primary

Matti Reinikainen

Role: primary

Ilkka Parviainen

Role: primary

Antti-Pekka Loisa

Role: primary

Harri Lemettinen

Role: primary

Mikko Järvisalo

Role: primary

Claire ROGER

Role: primary

04.66.68.30.50

Jean Yves LEFRANT

Role: backup

Jean François TIMSIT

Role: primary

01 40 25 77 02

Olivier JOANNES BOYAU

Role: primary

05 57 65 68 66

David BOUGON

Role: primary

04 50 63 60 30

George Dimopoulos

Role: primary

+30.210.5832182

Wai-Tat Wong

Role: primary

852-92544847

Fabio Guarracino

Role: primary

Emma Comandini

Role: primary

Roberta Caccese

Role: primary

Mario Venditti

Role: primary

0039 06491749

Giorgia Maiolo

Role: primary

3491652600

Ilaria De Domenici

Role: backup

3491652600

Nor'azim Mohd Yunos

Role: primary

+60177610588

Mohd Zulfakar Bin Mazlan

Role: primary

+60129091447

Janattul Ain Jamal

Role: primary

+60129572891

Mohd Basri Mat Nor

Role: primary

+60199822105

Mohd Shahnaz Hasan

Role: primary

+60192627277

Noor Airini Ibrahim

Role: primary

+60126497403

Roger Bruggemann

Role: primary

Joao Pedro Baptista

Role: primary

Ana Marques

Role: primary

João M Ribeiro

Role: primary

José M Pereira

Role: primary

Filomena Faria

Role: primary

João G Pereira

Role: primary

Sonia Luque

Role: primary

0034-93-2483825

Santiago Garu

Role: backup

0034-652128567

Jordi Rello

Role: primary

Raphael Manez

Role: primary

Gerardo Aguilar

Role: primary

+34 961973500 ext. 973848

References

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Roberts JA, Sime FB, Lipman J, Hernandez-Mitre MP, Baptista JP, Bruggemann RJ, Darvall J, De Waele JJ, Dimopoulos G, Lefrant JY, Mat Nor MB, Rello J, Seoane L, Slavin MA, Valkonen M, Venditti M, Ceccarelli G, Wong WT, Zeitlinger M, Roger C. Are contemporary antifungal doses sufficient for critically ill patients? Outcomes from an international, multicenter pharmacokinetics study for Screening Antifungal Exposure in Intensive Care Units-the SAFE-ICU study. Intensive Care Med. 2025 Feb;51(2):302-317. doi: 10.1007/s00134-025-07793-5. Epub 2025 Feb 3.

Reference Type DERIVED
PMID: 39899034 (View on PubMed)

Other Identifiers

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SAFE-ICU Protocol V2

Identifier Type: -

Identifier Source: org_study_id

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