ATB-PICU
Summary
Antibiotics are frequently used in Pediatric Intensive Care Units but we don’t know how long to give them to clear infections. Most of what is known about blood tests to diagnose infections is from studies on adult patients. But the immune system in children works somewhat differently than in adults. So we need to study how blood tests can be useful to diagnose severe infections in children.
We don’t know how long we should treat critically ill children with antibiotics to make sure that we clear infections. We tend to use antibiotics for a longer period than necessary to ensure infection cure. However, the more we use them, the higher the chance of developing resistant bacteria. We now know that resistant bacteria are becoming a common problem and can make it harder to treat infections in the future
The best way to reduce infections caused by resistant bacteria is to reduce unnecessary use of antibiotics. Thus, we are studying blood tests that can help us diagnose infections children who have been admitted to a pediatric intensive care unit and are being treated for a severe bacterial infection to evaluate if they could help us to better define when to stop antibiotics in a safe manner. This would reduce unnecessary antibiotic use and also decrease antibiotic related side effects and resistance. The infection biomarkers we will measure are called C-reactive protein and procalcitonin.
There are 4 Canadian children’s hospitals participating in this study. The Alberta Children’s Hospital plans to enroll 100 patients over 4 years
Eligibility
Eligible gender: Male, Female, Transgender, Other
Eligible ages: 1 to 18
Inclusion criteria:
1) Patient admitted to PICU
2) age greater than 1 month and less than 18 years
2) Patient has suspected or proven severe bacterial infection
3) In the previous 48 hours one or more antibiotic was given to the patient
Exclusion criteria:
1) Patients who were given antibiotics for more than 48 hours
2) Antibiotics given only to prevent infection after surgery and not to treat an infection
3) Age <1 month (very immature immunological system) and ≥18 years
4) Infections for which a long treatment is required (e.g., endocarditis, osteomyelitis),
5) Children who received antibiotics within 7 days prior to the diagnosis of severe bacterial infection
6) Pregnancy
7) Palliative care patients who do not want antibiotics given
8) Patients not expected to survive >24 hours according to PICU physician
9) Confirmed or suspected brain death
10) Patients on extracorporeal membrane oxygenation (ECMO)
11) Treating doctor does not wish patient to be enrolled
12) Patient/parent refusal
13) Unavailability of research personnel
14) Patients previously enrolled in the study
Participate
Additional information
Contact information
Recruitment is through admission to the Pediatric Intensive Care Unit at the Alberta Children's Hospital. Even though we are not recruiting directly via the external website inclusion on the website will build awareness of research at Alberta Children's Hospital and the transparency of studies being conducted in the PICU.
Principal investigator:
Theresa Wu
Clinical trial:
No
REB-ID:
REB17-0285