Intravenous Versus Oral Treatment of the Main Acute Infections
Intravenous Versus Oral Treatment of the Main Acute Infections in Emergency Departments
University of Southern Denmark
4,000 participants
Jan 15, 2025
INTERVENTIONAL
Conditions
Summary
Patients admitted to the hospital with acute infections are often treated with intravenous (IV) antibiotics. Around 70% of these infections fall into three categories: respiratory tract infections, urinary tract infections, and cellulitis. A Danish study found that 76% of patients admitted with suspected community-acquired pneumonia and treated with antibiotics received them intravenously. Based on an extrapolated estimate from an unpublished local survey, approximately 50,000 patients in Denmark are admitted each year for infections and treated with IV antibiotics. The average hospital stay for these patients is 5.9 days, resulting in a total of 295,000 hospital days annually, accounting for about 7% of total hospital admissions in Denmark. This represents an annual cost of 2.3 billion DKK. While some patients need hospitalization due to their overall health or other serious conditions, others remain hospitalized primarily to receive IV antibiotics. Expanding the use of oral antibiotics in emergency departments should be pursued only if it can demonstrate comparable efficacy and safety to IV administration. Therefore this study will investigate the efficiency of primarily oral antibiotics in acutely admitted patients with proven or suspected infections. Additionally, the investigators will evaluate the safety of oral regimen for these patients.
Eligibility
Inclusion Criteria2
- Suspected respiratory tract infection, urinary tract infection, or cellulitis by the attending physician
- Planned or initiated intravenous antibiotic treatment
Exclusion Criteria9
- if received more than two doses of intravenous antibiotics;
- systolic blood pressure \<90 mmHg;
- nausea and/or vomiting in more than one short-term instance during the last 2 days;
- suspected significantly reduced gastrointestinal absorption;
- confirmed plasma-lactate \> 2;
- pregnant or nursing;
- unable to give informed consent;
- severe immunodeficiency;
- urgent vital treatment needed.
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Interventions
Patients randomized to oral treatment will commence the oral treatment immediately. The oral treatment is based on specially developed treatment suggestions developed by microbiologists and specialists in infectious diseases from the participating regions, and in respect with local treatment guidelines (detailed described in the protocol).
Locations(7)
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NCT06715306