Effect of Antibiotic Choice On ReNal Outcomes (ACORN)

• Status: Enrolling by invitation
• Trial end date: 2024-02-01
• Target enrollment: 0
• Participant gender: All

Summary

Sepsis is one of the most common causes of acute illness and death in the United States. Early, empiric broad-spectrum antibiotics are a mainstay of sepsis treatment. Two classes of antibiotics with activity against Pseudomonas, anti-pseudomonal cephalosporins and anti-pseudomonal penicillins, are commonly used for acutely ill adults with sepsis in current practice. Recent observational studies, however, have raised concern that anti-pseudomonal penicillins may cause renal toxicity. Anti-pseudomonal cephalosporins, by comparison, may be associated with a risk of neurotoxicity. Rigorous, prospective data regarding the comparative effectiveness and toxicity of these two classes of medications among acutely ill patients are lacking. The investigator propose a randomized trial comparing the impact of anti-pseudomonal cephalosporins and anti-pseudomonal penicillins on renal outcomes of acutely ill patients.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Vanderbilt University Medical Center
• Treatments: Cephalosporins; Penicillins

Criteria

Inclusion Criteria:

• Age ≥ 18 years old

• Located in a participating emergency department or medical intensive care unit

• Less than 12 hours from presentation to study hospital

• Treating clinician initiating an order for an anti-pseudomonal cephalosporin or anti-pseudomonal penicillin

Exclusion Criteria:

• Known receipt of > 1 dose of an anti-pseudomonal cephalosporin or anti-pseudomonal penicillin during the last 7 days

• Current documented allergy to cephalosporins or penicillin

• Known to be a prisoner

• Treating clinicians feel that either an anti-pseudomonal cephalosporin or anti-pseudomonal penicillin is required or contraindicated for the optimal treatment of the patient, including for more directed antibiotic therapy against known prior resistant infections or suspected sepsis with an associated central nervous system infection