December 9, 2022

Launch of a study to test additional antibiotics treating abdominal infections

NHS patients who develop life-threatening abdominal infections will now be offered double the traditional dose of antibiotics in a new trial funded by the National Institute for Health and Care Research (NIHR).

Patients with life-threatening abdominal infections are usually given a two-week course, which often proves unsuccessful, but now NIHR-funded researchers from the University of York and the University of Leeds are studying whether a treatment A month’s antibiotic is effective in dealing with the infection.

The Extend Trial is co-led by Dr Andrew Kirby, Associate Professor at the University of Leeds Medical School and NHS Consultant in Microbiology, and Dermot Burke, Associate Professor of Surgery also at the University of Leeds Medical School.

Dr Andrew Kirby said: “There may be an aversion to prescribing longer antibiotic courses due to the risk of antimicrobial drug resistance. But these infections are extremely serious and current treatments do not work for a large proportion of patients. We want to see if a longer, fixed course cures more people – if it stops infection from coming back, prevents new infections and saves lives.

These types of infections occur when the intestine is damaged, often as a result of surgery or bowel disease, causing bacteria living in the intestine to leak into the surrounding cavity – abdominal infections are one a leading cause of sepsis in patients in intensive care units, which kills more people in the UK than breast, bowel and prostate cancer combined.

Longer courses of antibiotics can be controversial because they can increase the risk of bacteria finding a way to survive treatment, meaning antibiotics are no longer a viable tool to fight infection.

The problem with shorter courses of antibiotics is that 20% of patients are not cured at the end and 10% of patients die from their infection, although there are indications that four days of antibiotics can sufficient to treat serious abdominal infections.

Doctors currently rely on blood tests and patient-reported symptoms to decipher whether the infection has cleared up, but if the bacteria hasn’t been completely eradicated by antibiotic treatment, it can begin to recur, leading to a recurrence of infection and possibly more cases. of sepsis.

That’s why researchers now want to test a 28-day course of antibiotics, to see if they can cure these infections more effectively than the traditional two-week course, or just let a doctor decide when to stop the course.

Professor Andrew Ustianowski, NIHR Infections Joint National Specialty Leader, said: “Intra-abdominal infections and sepsis are very serious problems in our populations. We have a variety of antibiotics that can help, but we we need specific research to inform us on how best to use them, including for how long.

“This NIHR-funded study is therefore an important trial that I hope will have a direct beneficial impact on our future management of these infections.”

The trial will start this month and run for three years, following patients for six months – half will receive antibiotic treatment prescribed by their doctor, usually for a week or two, while the other half will receive 28 days of treatment.

More information about the study is available here.