RecruitingNot ApplicableNCT07481773

Biomarker Signature-Supported Antibiotic Treatment Decisions in ICU

Biomarker Signature-Supported Antibiotic Treatment Decisions in Intensive Care Units


Sponsor

McGill University Health Centre/Research Institute of the McGill University Health Centre

Enrollment

1,200 participants

Start Date

May 13, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this randomized clinical trial is to determine whether a biomarker-signature (BV) supported antibiotic treatment decision matrix can have a beneficial impact on antibiotic use and patient outcomes in an ICU population.


Eligibility

Min Age: 18 Years

Inclusion Criteria3

  • Admitted to the Intensive Care Unit (ICU)
  • Started on antibiotics for any suspected or confirmed infection in the preceding 72 hours (about 3 days)
  • Treating doctor(s) willing to consider BV test result in antibiotic treatment decision making

Exclusion Criteria11

  • Severe immunocompromise/immunosuppression
  • Congenital immunodeficiency
  • HIV with CD4 \< 20
  • Active chemotherapy and profound neutropenia (ANC \< 100) expected to last \> 7 days;
  • solid organ or stem cell transplant within preceding 6 months AND active GVHD
  • Receiving high dose steroids (Pred \> 20mg/day for \> or = 2 weeks)
  • Advanced metastatic cancer irrespective of treatment
  • Palliative intent, death imminent and inevitable within 4 weeks
  • Antibiotic to be discontinued within 24h (ex. Prophylaxis)
  • Active infection diagnosed and treated with antibiotics within preceding 2 weeks
  • Previously included during the same hospitalization

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Interventions

DIAGNOSTIC_TESTBiomarker-signature supported antibiotic treatment recommendation

The antibiotic treatment recommendation will be based on a decision matrix that combines the results of the BV-signature (a score ranging from 0 -100) with the clinical assessment of likelihood of bacterial infection.

DIAGNOSTIC_TESTClinical assessment for antibiotic treatment decision

Antibiotic treatment decision will be based on clinical assessment only (BV test result remains masked)


Locations(4)

Montreal General Hospital

Montreal, Quebec, Canada

Research Institute of McGill University Health Center (RI-MUHC)

Montreal, Quebec, Canada

Royal Victoria Hospital

Montreal, Quebec, Canada

Research Institute McGill University Health Centre

Montreal, Quebec, Canada

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NCT07481773


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