Extracorporeal Therapy and Therapeutic Drug Monitoring

NCT ID: NCT07287813

Last Updated: 2025-12-17

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

NOT_YET_RECRUITING

Total Enrollment

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-12-12

Study Completion Date

2027-01-31

Brief Summary

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The aim of this study is to comparatively evaluate serum concentrations of continuously applied antibiotics in ICU patients, with and without ECMO/RRT support.

Detailed Description

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Among all patients being treated with new generation antibiotics (beta.lactams and beta-lactamase inhibitors), we will take into consideration the results of those admitted to intensive care units.

Effective antimicrobial treatment is critical to reduce their mortality associated with bacterial sepsis. They often also require extracorporeal supports, such as renal replacement therapy (RRT) and extracorporeal membrane oxygenation (ECMO), for their survival. However, few studies, limited only to some drugs, report the importance of therapeutic drug monitoring for adequate dose adjustment in these particular conditions of extracoporeal support.

The risk of reaching sub therapeutic or toxic levels is quite high, due to possible very significant variations in the pharmacokinetics of the drugs because of their interaction with the various components of the ECMO and RRT devices, the characteristics of the drug itself and the pathophysiological changes of the patients on ECMO and/or RRT.

Primary aim is to evaluate whether the standard prescriptions of beta lactams/beta lactamase inhibitors (BL/BLIs) are adequate to achieve the optimal PK/PD target also for ECMO and RRT (or combined) patients admitted to intensive care unit.

Secondary aims include to evaluate:

* the occurrence of sub-therapeutic and/or toxic drugs levels
* the proportion of patients with insufficient drugs levels in different subgroups (i.e., absence of extracorporeal therapy vs. ECMO; absence of extracorporeal therapy vs. RRT, absence of extracorporeal therapy vs ECMO and RRT) - the proportion of patients with toxic or sub-therapeutic drugs levels in the same subgroups;
* the proportion, when possible, of drugs level before and during the extracorporeal therapy, for the same patient;
* the occurrence of drug resistance by pathogens and their mechanism

Conditions

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ICU Patients With ECMO And-or RRT and With Gram Negative Infections Susceptible to BL-BLIs

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* adult patients (age 18y or older)
* admitted to ICU
* supported or not-supported with extracorporeal membrane oxygenation (ECMO) and/or renal replacement therapy (RRT)
* affected by gram-negative bacterial infections susceptible to the novel antibiotics.

Exclusion Criteria

* Pediatric age (\<18y)
* allergies to pharmaceutical and/or inactive drug ingredients (excipients)
* life expectancy less than 1 month
* body mass index (BMI) \>45 kg/m2
* pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondazione IRCCS Policlinico San Matteo di Pavia

OTHER

Sponsor Role lead

Responsible Party

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Simona De Gregori

PhD in Chemical Sciences

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Fondazione IRCCS Policlinico San Matteo

Pavia, Lombardy, Italy

Site Status

Countries

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Italy

Central Contacts

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Simona De Gregori

Role: CONTACT

Phone: +39 0382503647

Email: [email protected]

Facility Contacts

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Simona De Gregori

Role: primary

Other Identifiers

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BL/BLIs in ICU - 2024

Identifier Type: -

Identifier Source: org_study_id