Sepsis, a life-threatening condition affecting tens of thousands annually in the UK, is the focus of the SepTiC trial, which seeks to improve treatment strategies. The study, led by Professor Anthony Gordon, addresses critical questions about antibiotic use, fluid management, and immune support to refine patient care and outcomes.
Rapid Testing for Targeted Antibiotic Use
The SepTiC trial is investigating the utility of rapid PCR testing to quickly identify the specific infections causing sepsis. Current practice involves administering broad-spectrum antibiotics while awaiting test results, which can take several days. The rapid PCR testing aims to expedite the identification process, allowing for the use of more targeted antibiotics.
"This has two potential benefits," explains Professor Gordon. "Firstly that patients get the targeted treatment they need more quickly, but secondly it could reduce the use of very powerful, wide-ranging antibiotics, which contribute to the issue of anti-microbial resistance."
Reducing the reliance on broad-spectrum antibiotics is crucial in combating antimicrobial resistance (AMR), a significant contributor to sepsis prevalence. Infections resistant to multiple antibiotics increase the risk of sepsis, making the development of targeted treatment strategies essential.
Fluid Management Optimization
The trial is also examining the optimal approach to fluid administration in sepsis patients. While administering fluids is a standard practice to maintain blood flow to organs, there is uncertainty regarding the appropriate amount. The SepTiC study is assessing whether removing excess fluid after initial stabilization can improve organ recovery.
"Evidence suggests some patients may benefit from a reduction in fluids once their condition begins to improve," notes Professor Gordon. "This is because additional fluid may later impair the blood flow to the organs, meaning they can’t recover and work properly."
Immune System Support with GM-CSF
Another aspect of the SepTiC trial involves evaluating the use of granulocyte-macrophage colony-stimulating factor (GM-CSF), also known as Sargramostim, to stimulate the immune system. Sepsis can weaken the immune system, increasing the risk of subsequent infections. Researchers are investigating whether GM-CSF can reduce this risk and improve overall recovery.
Trial Details and Recruitment
The SepTiC study, funded by the National Institute for Health & Care Research (NIHR), is actively recruiting patients across multiple sites in the UK. The trial aims to enroll participants from up to 60 sites over the next nine months, with the goal of providing more effective treatment and improving the quality of life and survival rates for sepsis patients. Current recruitment sites include Imperial College Healthcare NHS Trust hospitals, King’s Mill Hospital, Queen Alexandra Portsmouth, Bristol Royal Infirmary, Kettering General Hospital, St George’s Hospital, James Cook University Hospital and Russells Hall Hospital.
