UMC Utrecht conducts a great deal of scientific research into preventing or limiting antibiotic resistance. In one of these studies, researchers look at which antibiotic treatment works best for patients who are hospitalized with blood poisoning (sepsis). This will enable us to optimize antibiotic treatments in the future and to design a careful antibiotic policy. And: it helps limit the development of antibiotic resistance.
Sepsis is a life-threatening condition and is caused by a dysregulated inflammatory response of the body to pathogens. This usually requires hospitalization and treatment with antibiotics. Hospitals still treat patients who come to the emergency department with sepsis in different ways: doctors immediately start with a combination treatment of two different antibiotics or they give only one antibiotic. However, there is no convincing evidence that such a combination treatment also leads to a better outcome for the patient. And the available studies on this show no difference between the two treatments. This is because they either had too few participants or because they did not have the right study design.
Antibiotic resistance
Antibiotics are medicines that are used if you have an infection caused by a bacteria. Bacteria can become insensitive (resistant) to antibiotics. The antibiotics cannot kill or slow down the bacteria. Antibiotics then no longer work. This is called antibiotic resistance. An infection by a resistant bacteria is more difficult to treat.
A combination of antibiotics or one antibiotic
A new study – coordinated by UMC Utrecht – is investigating whether a standard treatment with the antibiotic ceftriaxone (a cephalosporin antibiotic) works just as well as a combination of cefuroxime and a short-term aminoglycoside antibiotic (such as gentamicin or tobramycin) in sepsis patients. The researchers mainly look at the efficacy, safety and cost-effectiveness of these treatment options.
Physician-researcher and coordinator of the study Eva Koekenbier (research program Epidemiology of Infectious Diseases, UMC Utrecht) explains: “In the context of the prevention of antibiotic resistance, it is very important that, in the event of a bacterial infection, we treat the patient as quickly as possible and with the most appropriate antibiotic (or combination of antibiotics). This new study contributes to the prudent use of antibiotics.”
National research
The aim of this national study with more than 3,000 patients is to determine whether a combination therapy of two antibiotics gives a better outcome than monotherapy (one antibiotic). Eva: “Our researchers look at survival, the length of hospital admission, the number of days of antibiotic treatment and readmissions, among other things. They also investigate cost-effectiveness and quality of life in the longer term. In the study – financially supported by ZonMw – nine Dutch hospitals (both UMCs and general hospitals) are working together to achieve results as quickly as possible. We expect to have these available in about three years.”
Tailor-made antibiotic treatment for each patient
The outcomes of this study will influence national guidelines for the treatment of patients with sepsis. Eva Koekenbier says: “With the help of the outcome of this study, we hope to be able to adjust the national guidelines for antibiotic use. As a result, every patient with sepsis will be able to receive the right antibiotic treatment based on sound scientific research in the future. By properly researching the best choice for these patients, the results of our study contribute to a prudent antibiotic policy, which inhibits the development of antibiotic resistance.”
The best antibiotic treatment for every patient
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