Beta-Glucan Driven vs. Empirical Antifungal Therapy in Critically Ill Patients
(1-3)-Beta-D-Glucan Driven vs. Empirical Antifungal Therapy in High Risk Critically Ill Patients A Randomized Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
-
Rome, Italy, 00168
- Gennaro De Pascale
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ICU admission (minimum of 48 hours in ICU with an expected length of stay of at least 48 hours)
- Ongoing Mechanical Ventilation
- Presence of CVC
- Sepsis/Septic Shock development while receiving broad spectrum antibiotics
- Positivity of Candida Score or Candida Colonization Index in absence of septic shock
Exclusion Criteria:
- Complicated Candida Infection
- Already ongoing anti fungal therapy
- Beta Glucan test not available
- Absence of informed consent
- Immunesuppressive status (long-term immunesuppresive or steroids therapy; AIDS; WBC <1000/mmc or neutrophils <500/mmc)
- Pregnancy
- Already enrolled in other interventional studies
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Control Group
Patients undergoing empirical anti fungal therapy.
Interruption of anti fungal treatment will be decided on the basis of standard clinically and microbiologically criteria.
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|
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Experimental: 1-3 Beta-D-Glucan Group
Patients undergoing anti fungal de-escalation according to 1-3 Beta-D-Glucan results
|
Patients in the study group will stop antifungals in presence of a negative result of Beta Glucan Test
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Reduction of anti fungal duration in the Beta Glucan group compared with standard empirical approach
Time Frame: First 30 days from enrollment
|
First 30 days from enrollment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Clinical Cure of Invasive Canididiasis
Time Frame: 90 days
|
90 days
|
|
|
Microbiological eradication of Invasive Candidiasis
Time Frame: 90 days
|
90 days
|
|
|
30-day mortality
Time Frame: 30 days
|
30 days
|
|
|
ICU mortality
Time Frame: 90 days
|
Any cause ICU mortality within three months from enrollment
|
90 days
|
|
Hospital mortality
Time Frame: 90 days
|
Any cause hospital mortality within three months from enrollment
|
90 days
|
|
Duration of ICU length of stay
Time Frame: 90 days
|
90 days
|
|
|
Duration of mechanical ventilation
Time Frame: 90 days
|
90 days
|
|
|
Number of invasive Candida Infections and Beta-Glucan accuracy
Time Frame: 90 days
|
90 days
|
|
|
Cost evaluation (empirical anti fungal therapy vs. Beta Glucan test)
Time Frame: 30 days
|
30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Disease Attributes
- Critical Illness
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents, Local
- Anti-Infective Agents
- Enzyme Inhibitors
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Cytochrome P-450 CYP3A Inhibitors
- Cytochrome P-450 Enzyme Inhibitors
- Hormone Antagonists
- Steroid Synthesis Inhibitors
- 14-alpha Demethylase Inhibitors
- Cytochrome P-450 CYP2C9 Inhibitors
- Antifungal Agents
- Clotrimazole
- Miconazole
Other Study ID Numbers
Other Study ID Numbers
- 100452
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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