Sepsis
Conditions
Interventions
Ceftriaxon monotherapy vs cefuroxime with short-course aminoglycoside (gentamicin or tobramycin)
Sponsors
University Medical Center Utrecht
Eligibility
Inclusion criteria
Inclusion criteria: 1) Age >= 18 years 2) Presenting to the ER 3) Suspicion of bacterial infection of unknown origin, primary suspected urinary origin or primary suspected abdominal origin. 4) National Early Warning Score (NEWS) or Modified Early Warning Score (MEWS) = 5. 5) Requiring intravenous antibiotic treatment and hospitalization.
Exclusion criteria
Exclusion criteria: 1) Working diagnosis at the ER of pneumonia. 2) Chemotherapy induced neutropenia as this is considered a separate entity in the guidelines. 3) Pre-existing renal failure defined as a GFR < 30, due to a relative contra-indication for aminoglycosides. 4) Allergy for cephalosporins or aminoglycosides, known prior to the start of treatment. 5) Indication for empirical coverage of ESBL-producing gram-negative bacteria according to the Dutch sepsis guidelines, i.e. known colonization or infection with ESBL-producing gram-negative bacteria in the prior year.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 30-day all-cause mortality | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcomes include duration of IC and hospital admission, quality of life, nephrotoxicity, ototoxicity and costs. In a cost-effectiveness analysis we will determine the costs per quality-adjusted life year gained. | — |
Contacts
Public ContactSharon van den Eijnde
UMC Utrecht
Outcome results
None listed