Efficacy and safety of 7 versus 14 days of antibiotic treatment for bacteremia produced by Pseudomonas aeruginosa: a multicenter, randomized (SHORTEN-2) clinical trial with a DOOR/RADAR analysis.
- Conditions
- Bacteriemia producida por P. aeruginosa.MedDRA version: 20.0Level: LLTClassification code: 10021860Term: Infection Pseudomonas aeruginosa Class: 10021881Therapeutic area: Diseases [C] - Bacterial Infections and Mycoses [C01]
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 306
Adult patients (18 years or older)., Present bacteremia due to P. aeruginosa., Having received 6 days (+/-1) of active antibiotic treatment against bacteremia counted from the date of extraction of the first positive blood culture and until the moment of randomization., Have signed the informed consent for the trial.
Minors under 18 years of age., Polymicrobial bacteremia including microorganisms other than P. aeruginosa. Polymicrobial bacteremia is considered the isolation in blood of more than one bacteria other than P.aeruginosa with clinical significance. P.aeruginosa bacteremias that are accompanied by isolates considered as contaminations (coagulase-negative staphylococci or viridans group streptococci, etc.) without clinical significance can be recruited for the trial, since these will not require specific treatment, and should not be considered polymicrobial bacteremia for the purposes of the assay., Patients in palliative care or with an expected survival of less than 48 hours at the time of randomization., Bacteremia due to P. aeruginosa in the previous 30 days as long as the previous infection has not been resolved., The doctor responsible for the patient does not want to include the patient in the clinical trial., Pregnant or breastfeeding women. Potentially fertile patients must have a negative pregnancy test., Focus of bacteremia not adequately controlled at least 72 hours before randomization., Bacteremia secondary to an infection that necessarily requires prolonged antibiotic treatment, greater than 7 days, including: -Post-obstructive or necrotizing pneumonia. -Lung abscesses. -Acute prostatitis. -Bone and joint infections. -Central nervous system infections. -Endovascular infections related to vascular prostheses. -Any other at the discretion of the doctor responsible for the patient., Coexistence of a different infection at the time of diagnosis of bacteremia that also requires antibiotic treatment if their treatment will be extended beyond 7 days from the diagnosis of bacteremia by P. aeruginosa. On the contrary, in the event that an infection coexists whose treatment ends before randomization, the patient may be included. Also in case there are isolates other than P. aeruginosa in samples corresponding to colonizations that do not require antibiotic treatment (asymptomatic bacteriuria, contamination of blood cultures by colonizers usual, bronchoaspirates without symptoms or signs suggestive of infection respiratory), the patient may be included in the trial.., Bacteremic pneumonia in severely immunocompromised patients, defined as: -Patients with severe neutropenia (<500 cells/mm3). -Recipients of allogeneic hematopoietic stem cell or solid organ transplant, during the first year after the transplant. -Active graft-versus-host disease requiring immunosuppressive treatment. -Patients with solid tumors who are receiving chemotherapy. -Untreated HIV infection with CD4 < 200 cells/mm3. -Patients with primary combined immunodeficiency. -Steroid treatment with prednisone > 20 mg/day (or equivalent) for 14 days prior to randomization., Bacteremia of any origin in patients with severe neutropenia (<500 cells/mm3) at the time of randomization., Bacteremia of any origin in large burns., Bacteremia produced by strains resistant to all beta-lactams and quinolones.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method