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针对社区获得性肺炎的随机、嵌入式、多因素适应性平台试验 (REMAP-CAP)

2026年10月30日 更新者：Lennie Derde、UMC Utrecht

REMAP-CAP is a randomised, embedded, multifactorial, adaptive platform trial for community-acquired pneumonia.

The purpose of this study is to evaluate the effect of a range of interventions to improve outcome of hospitalised patients admitted to intensive care with respiratory tract infections.

In addition, REMAP-CAP provides and adaptive research platform for evaluation of multiple treatment modalities in the event of a respiratory pandemic such as COVID-19.

REMAP-COVID is a sub-platform of REMAP-CAP that evaluates treatments specific to COVID-19 in the United States of America.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

Background: Respiratory tract infections that are of sufficient severity to require admission to hospital are associated with substantial mortality. All hospitalized patients with respiratory tract infections will receive therapy that consists of a combination of multiple different treatments. For many of these treatments, different options are available currently. For example, several antibiotics exist that are active against the microorganisms that commonly cause pneumonia but it is not known if one antibiotic strategy is best, or whether all suitable antibiotic strategies have similar levels of effectiveness. Of all the treatments that clinicians use for patients with respiratory tract infections, only a small minority have been tested in randomized controlled trials to determine their comparative effectiveness. As a consequence, the standard treatments that are administered vary between and within countries. Current conventional clinical trials methods to assess the efficacy of treatments for respiratory tract infections generally compare two treatment options (either two options for the same treatment modality, where both are in common use; or a new treatment against no treatment or placebo, where the effectiveness of the new treatment is not known). Using this approach, in a series of separate and sequential trials, it will take an inordinate length of time to study all the treatment options. Additionally, with conventional trial designs it is not possible to evaluate interactions between treatment options.

Aim: The primary objective of this platform trial is, for patients hospitalized with respiratory tract infection, to identify the effect of a range of interventions to improve patient outcomes.

Methods: The study will enroll hospitalized patients with respiratory tract infection using a trial design known as a REMAP, which is a type of platform trial. Within this platform trial, eligible participants will be randomized to receive one intervention in each of one or more domains. The primary outcome is a composite of 90-day all-cause mortality and, among survivors, a daily ordinal scale analyzed as a trajectory of illness and recovery to 28-days. There will also be both Platform and domain-specific secondary outcome measures.

In a conventional trial enrollment continues until a pre-specified sample size is obtained, at which time enrollment ceases and the trial data are analyzed to obtain a result. The possible results are that a difference is detected, or no that no difference is detected. However, when the conclusion of the statistical test is "no difference", this could reflect that there truly is no meaningful difference or that the result is indeterminate (i.e., it is possible that if more patients had been enrolled a clinically relevant difference may have been detected).

In comparison to a conventional trial this Platform uses an adaptive design that:

  • avoids indeterminate results by concluding an answer to a question when sufficient data have accrued (not when a pre-specified sample is reached);
  • utilizes already accrued data to increase the likelihood that patients within the trial are more likely to be randomized to treatments that are more likely to be beneficial;
  • is intended to be perpetual (or at least open-ended), substituting new questions in series as initial questions are answered; and
  • can evaluate the interaction between interventions in different domains, added at different timepoints into the Platform.

Bayesian statistical methods will be used to define Statistical Triggers that reflect thresholds for decision making within a domain. While a limited number of initial treatments and treatment domains were specified at initiation, other interventions and domains have been evaluated over time, and it is planned that this platform trial will continue to evaluate other treatments in the future. Furthermore, in the event of a future epidemic, this Platform is able to adapt to evaluate the most relevant treatment options.

研究类型

介入性

注册 (估计的)

20000

阶段

  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

学习地点

  • 以色列
      • Haifa、以色列、3109601
        • 撤销
        • Rambam Medical Center
      • Petah Tikva、以色列、4941492
        • 暂停
        • Beilinson Hospital, Rabin Medical Center
      • Poria – Neve Oved、以色列、1528001
        • 撤销
        • The Baruch Padeh Medical Center
  • 克罗地亚
      • Požega、克罗地亚、34000
        • 招聘中
        • General County Hospital Požega
        • 接触：
          • Zdravko Andrić, MD
      • Zagreb、克罗地亚、10000
        • 招聘中
        • University Hospital Centre Zagreb
        • 接触：
          • Ana Vujaklija Brajković, MD
      • Zagreb、克罗地亚、10000
        • 撤销
        • University Hospital for Infectious Diseases
  • 加拿大
    • Alberta
      • Calgary、Alberta、加拿大、T2W 1S7
        • 主动，不招人
        • Foothills Medical Centre
      • Calgary、Alberta、加拿大、T2W 1S7
        • 主动，不招人
        • Peter Lougheed Centre
      • Calgary、Alberta、加拿大、T2W 1S7
        • 主动，不招人
        • Rockyview General Hospital
      • Calgary、Alberta、加拿大、T2W 1S7
        • 主动，不招人
        • South Health Campus
      • Edmonton、Alberta、加拿大、T5H 3V9
        • 招聘中
        • Royal Alexandra Hospital, Alberta
        • 接触：
          • Demetrios Kutsogiannis, MD
      • Edmonton、Alberta、加拿大、T6G 2C8
        • 招聘中
        • University of Alberta Hospital
        • 接触：
          • Wendy Sligl, MD
    • British Columbia
      • Surrey、British Columbia、加拿大、V3V 1Z2
        • 尚未招聘
        • Surrey Memorial Hospital
        • 接触：
          • Anish Mitra, MD
    • Manitoba
      • Winnipeg、Manitoba、加拿大、R3A 1R9
        • 招聘中
        • Health Sciences Centre Winnipeg
        • 接触：
          • Ryan Zarychanski, MD
      • Winnipeg、Manitoba、加拿大、R2H 2A6
        • 招聘中
        • St Boniface General Hospital
        • 接触：
          • Ryan Zarychanski, MD
      • Winnipeg、Manitoba、加拿大、R3J 3M7
        • 招聘中
        • Grace Hospital
        • 接触：
          • Gloria Vazquez-Grande, MD
    • New Brunswick
      • Fredericton、New Brunswick、加拿大、E3B 4R3
        • 尚未招聘
        • Dr. Everett Chalmers Regional Hospital
        • 接触：
          • Zeeshan Aslam, MD
      • Fredericton、New Brunswick、加拿大、E3B 4R3
        • 尚未招聘
        • The Moncton Hospital
        • 接触：
          • Daniel Smyth, MD
      • Fredericton、New Brunswick、加拿大、E3B 4R3
        • 尚未招聘
        • The Saint John General Hospital
        • 接触：
          • Stephen Robinson, MD
    • Ontario
      • Brampton、Ontario、加拿大、L6R 3J7
        • 招聘中
        • William Osler Health System
        • 接触：
          • Alexandra Binnie, MD
      • Brantford、Ontario、加拿大、N3R 1G9
        • 招聘中
        • Brantford General Hospital
        • 接触：
          • Brenda Reeve, MD
      • Hamilton、Ontario、加拿大、L8N 4A6
        • 招聘中
        • St. Joseph's Healthcare Hamilton
        • 接触：
          • Deborah Cook, MD
      • Hamilton、Ontario、加拿大、L8L 8E7
        • 招聘中
        • Juravinski Hospital
        • 接触：
          • Bram Rochwerg, MD
      • Hamilton、Ontario、加拿大、L8L 8E7
        • 招聘中
        • Hamilton general Hospital
        • 接触：
          • Alison Fox-Robichaud, MD
      • Kingston、Ontario、加拿大、K7L 2V7
        • 主动，不招人
        • Kingston Health Sciences Centre
      • Kitchener、Ontario、加拿大、N2G 4K9
        • 招聘中
        • Grand River Hospital
        • 接触：
          • Theresa Liu, MD
      • Kitchener、Ontario、加拿大、N2M 1B2
        • 招聘中
        • St Mary's General Hospital
        • 接触：
          • Rebecca Kruisselbrink, MD
      • Ottawa、Ontario、加拿大、K1H 8L6
        • 招聘中
        • The Ottawa Hospital
        • 接触：
          • Lauralyn McIntyre, MD
      • Saint Catharines、Ontario、加拿大、L2S 0A9
        • 招聘中
        • Niagara Health
        • 接触：
          • Jennifer Tsang, MD
      • Thunder Bay、Ontario、加拿大、P7B 6V4
        • 主动，不招人
        • Thunder Bay General Hospital
      • Toronto、Ontario、加拿大、M5G 2C4
        • 招聘中
        • Toronto General Hospital
        • 接触：
          • Lorenzo del Sorbo, MD
      • Toronto、Ontario、加拿大、M4N 3M5
        • 招聘中
        • Sunnybrook Health Sciences Centre
        • 接触：
          • Rob Fowler, MD
      • Toronto、Ontario、加拿大、M5T 2S8
        • 招聘中
        • Toronto Western Hospital
        • 接触：
          • Elizabeth Wilcox, MD
      • Toronto、Ontario、加拿大、M5G 1X5
        • 招聘中
        • Mount Sinai Hospital
        • 接触：
          • Sangeeta Mehta, MD
      • Toronto、Ontario、加拿大、M5B 1W8
        • 招聘中
        • St. Michael's Hospital Unity Health Toronto
        • 接触：
          • John Marshall, MD
      • Toronto、Ontario、加拿大、M6R 1B5
        • 主动，不招人
        • St Joseph's Health Centre
    • Quebec
      • Lévis、Quebec、加拿大、G6V 3Z1
        • 尚未招聘
        • CIUSS Chaudieres-Appalaches (Levis)
        • 接触：
          • Patrick Archambault, MD
      • Montreal、Quebec、加拿大、H3H 2R9
        • 招聘中
        • McGill University Health Centre
        • 接触：
          • Kosar Khwaja, MD
      • Montreal、Quebec、加拿大、H2X 0A9
        • 招聘中
        • Centre Hospitalier de l'Universite de Montreal
        • 接触：
          • Michael Chasse, MD
      • Montreal、Quebec、加拿大、H1T 2M4
        • 主动，不招人
        • Hospital Maisonneuve-Rosemont
      • Montreal、Quebec、加拿大、H2B 1K3
        • 尚未招聘
        • Hôpital Fleury
        • 接触：
          • Thomas Hemmerling, MD
      • Montreal、Quebec、加拿大、H4J 1C5
        • 招聘中
        • Hopital du Sacre-Coeur de Montreal
        • 接触：
          • Martin Albert, MD
      • Québec、Quebec、加拿大、G1V 4G5
        • 招聘中
        • IUCPQ-UL
        • 接触：
          • Francois Lellouche, MD
      • Québec、Quebec、加拿大、G1R 2J6
        • 招聘中
        • CHU de Québec - Université Laval
        • 接触：
          • Alexis Turgeon, MD
      • Sherbrooke、Quebec、加拿大、J1J 3H5
        • 招聘中
        • Centre Hospitalier de l'Université de Sherbrooke
        • 接触：
          • Francois Lamontagne, MD
    • Saskatchewan
      • Saskatoon、Saskatchewan、加拿大、S7K 0M7
        • 招聘中
        • Regina General Hospital
        • 接触：
          • Eric Sy, MD
  • 匈牙利
      • Nyíregyháza、匈牙利、4400
        • 完全的
        • Jósa András County Hospital
      • Ózd、匈牙利、3600
        • 完全的
        • Almási Balogh Pál Kórház
  • 印度
    • Tamil Nadu
      • Chennai、Tamil Nadu、印度、600006
        • 主动，不招人
        • Apollo Main Hospital
      • Chennai、Tamil Nadu、印度、600010
        • 招聘中
        • Apollo First Med Hospital
        • 接触：
          • Meghena Mathew, MD
      • Chennai、Tamil Nadu、印度、600095
        • 主动，不招人
        • Apollo Vanagaram Hospital
      • Chennai、Tamil Nadu、印度、600096
        • 招聘中
        • Apollo Speciality Hospital - OMR
        • 接触：
          • Deva Jayakumar, MD
  • 哥伦比亚
    • Cundinamarca
      • Chía、Cundinamarca、哥伦比亚
        • 招聘中
        • Universidad de La Sabana
  • 塞尔维亚
      • Belgrade、塞尔维亚、11000
        • 暂停
        • University Hospital Center Dr Dragiša Mišović
      • Belgrade、塞尔维亚、11000
        • 暂停
        • University Clinical Centre of Serbia
      • Niš、塞尔维亚、18000
        • 招聘中
        • Clinical Centre of Niš
        • 接触：
          • Tanja Pejčić, MD
  • 尼泊尔
      • Bharatpur、尼泊尔、44200
        • 招聘中
        • Chitwan Medical College
        • 接触：
          • Basanta Gauli, MD
      • Kathmandu、尼泊尔、44600
        • 招聘中
        • Grande International Hospital
        • 接触：
          • Sushil Khanal, MD
      • Kathmandu、尼泊尔、44600
        • 招聘中
        • Hospital for Advanced Medicine and Surgery (HAMS)
        • 接触：
          • Hem Paneru, MD
      • Kathmandu、尼泊尔、44600
        • 招聘中
        • Nepal Mediciti
        • 接触：
          • Diptesh Aryal, MD
  • 巴基斯坦
    • Sindh
      • Karachi、Sindh、巴基斯坦、75000
        • 招聘中
        • Ziauddin University Hospital Clifton Campus
        • 接触：
          • Madiha Hashmi, MD
      • Karachi、Sindh、巴基斯坦、75300
        • 招聘中
        • Abbasi Shaheed Hospital
        • 接触：
          • Aneela Kidwai, MD
      • Karachi、Sindh、巴基斯坦、75510
        • 招聘中
        • National Institute of Cardiovascular Diseases, Karachi
        • 接触：
          • Nawal Salahuddin, MD
      • Karachi、Sindh、巴基斯坦、75600
        • 招聘中
        • South City Hospital, Karachi
        • 接触：
          • Nasir Khoso, MD
      • Karachi、Sindh、巴基斯坦
        • 招聘中
        • Ziauddin University North Nazimabad Campus
        • 接触：
          • Quratul Ain, MD
  • 德国
      • Berlin、德国、10117
        • 撤销
        • Charité - Universitätsmedizin Berlin - Infektiologie und Pneumologie
      • Berlin、德国、12351
        • 完全的
        • Vivantes Klinikum Neukölln
      • Berlin、德国、13509
        • 撤销
        • Vivantes Humboldt-Klinikum
      • Berlin、德国、13353
        • 暂停
        • Charite Universitätsmedizin Berlin
      • Cologne、德国、50937
        • 撤销
        • University Hospital of Cologne
      • Cottbus、德国、03058
        • 完全的
        • Carl-Thiem-Klinikum Cottbus
      • Dortmund、德国、44137
        • 完全的
        • Klinikum Dortmund
      • Essen、德国、45138
        • 完全的
        • Elisabeth Hospital Essen
      • Frankfurt、德国、60590
        • 撤销
        • Universitätsklinikum Frankfurt
      • Hamburg、德国、20251
        • 暂停
        • University Medical Center Hamburg-Eppendorf (UKE)
      • Jena、德国、07747
        • 暂停
        • Universitätsklinikum Jena
      • Leipzig、德国、04103
        • 暂停
        • University Hospital Leipzig
      • Leipzig、德国、04103
        • 暂停
        • Universitätsklinikum Leipzig
      • München、德国、81675
        • 暂停
        • Klinikum rechts der Isar der TU München
      • Münster、德国、48149
        • 暂停
        • Universitätsklinikum Münster
      • Tübingen、德国、72076
        • 完全的
        • Universitäts Klinikum Tübingen
      • Würzburg、德国、97080
        • 暂停
        • Universitätsklinikum Würzburg
  • 意大利
      • Brescia、意大利、25123
        • 招聘中
        • AO Spedali Civili di Brescia
        • 接触：
          • Simone Piva, MD
      • Milan、意大利、20132
        • 招聘中
        • IRCCS Ospedale San Raffaele
        • 接触：
          • Giovanni Landoni, MD
      • Milan、意大利、20089
        • 招聘中
        • Humanitas Research Hospital
        • 接触：
          • Maurizio Cecconi, MD
      • Milan、意大利、20122
        • 招聘中
        • Ca' Granda Ospedale Maggiore Policlinico
        • 接触：
          • Francesco Blasi, MD
      • Palermo、意大利、90127
        • 招聘中
        • Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone
        • 接触：
          • Andrea Cortegiani, MD
      • Palermo、意大利、90127
        • 招聘中
        • Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione
        • 接触：
          • Gennaro Martucci, MD
      • Reggio Emilia、意大利、42123
        • 招聘中
        • Arcispedale S. Maria Nuova
        • 接触：
          • Elena Mantovani, MD
      • Rimini、意大利、47923
        • 尚未招聘
        • Ospedale Infermi di Rimini
        • 接触：
          • Jonathan Montomoli, MD
  • 捷克语
      • Prague、捷克语、10000
        • 招聘中
        • Fakultní nemocnice Královské Vinohrady
        • 接触：
          • František Duška, MD
      • Teplice、捷克语、41501
        • 暂停
        • Teplice Hospital
  • 斯洛文尼亚
      • Golnik、斯洛文尼亚、4204
        • 暂停
        • University Clinic of Respiratory and Allergic Diseases Golnik
      • Maribor、斯洛文尼亚、2000
        • 招聘中
        • University Medical Centre Maribor
        • 接触：
          • Andre Markota, MD
  • 新西兰
      • Auckland、新西兰、0620
        • 招聘中
        • North Shore Hospital
        • 接触：
          • Robert Everitt, MD
      • Auckland、新西兰、1023
        • 招聘中
        • CVICU, Auckland City Hospital
        • 接触：
          • Shay McGuinness, MD
      • Auckland、新西兰、1023
        • 招聘中
        • DCCM, Auckland City Hospital
        • 接触：
          • Colin McArthur, MD
      • Auckland、新西兰、2104
        • 招聘中
        • Middlemore Hospital
        • 接触：
          • Tony Williams, MD
      • Christchurch、新西兰、8011
        • 招聘中
        • Christchurch Hospital
        • 接触：
          • Jay Ritzema-Carter, MD
      • Hamilton、新西兰、3204
        • 招聘中
        • Waikato Hospital
        • 接触：
          • Robert Martynoga, MD
      • New Plymouth、新西兰、4310
        • 招聘中
        • Taranaki Base Hospital
        • 接触：
          • Jonathan Albrett, MD
      • Rotorua、新西兰、3010
        • 招聘中
        • Rotorua Hospital
        • 接触：
          • Ulrike Buehner, MD
      • Tauranga、新西兰、3112
        • 招聘中
        • Tauranga Hospital
        • 接触：
          • Troy Browne, MD
      • Wellington、新西兰、6021
        • 招聘中
        • Wellington Regional Hospital
        • 接触：
          • Paul Young, MD
      • Whangarei、新西兰、0148
        • 招聘中
        • Whangarei Hospital
        • 接触：
          • Ralph Fuchs, MD
  • 日本
    • Kanagawa
      • Kawasaki、Kanagawa、日本、216-8511
        • 招聘中
        • St Marianna University School of Medicine
      • Yokohama、Kanagawa、日本、236-0004
        • 招聘中
        • Yokohama City University Hospital
      • Yokohama、Kanagawa、日本、241-0811
        • 招聘中
        • St. Marianna University Yokohama City Seibu Hospital
    • Kumamoto
      • Minami、Kumamoto、日本、861-4193
        • 招聘中
        • Saiseikai Kumamoto Hospital
    • Osaka
      • Osaka、Osaka、日本、534-0021
        • 招聘中
        • Osaka City General Hospital
    • Tokyo
      • Tokyo、Tokyo、日本、130-8575
        • 招聘中
        • Nerima Hikarigaoka Hospital
      • Tokyo、Tokyo、日本、130-8575
        • 招聘中
        • Tokyo Metropolitan Bokutoh Hospital
      • Tokyo、Tokyo、日本、174-0051
        • 招聘中
        • Itabashi Chuo Medical Center
      • Tokyo、Tokyo、日本、279-0001
        • 招聘中
        • Tokyo bay Urayasu-Ichikawa Medical Center
    • Wakayama
      • Wakayama、Wakayama、日本、641-8509
        • 招聘中
        • Wakayama Medical University
  • 比利时
      • Charleroi、比利时、6042
        • 招聘中
        • CHU de Charleroi - Hôpital Civil Marie Curie
        • 接触：
          • Patrick Biston, MD
      • Ghent、比利时、9000
        • 招聘中
        • Universitair Ziekenhuis Gent
        • 接触：
          • Pieter Depuydt, Prof.
      • Namur、比利时、5530
        • 招聘中
        • CHU Namur site Godinne
        • 接触：
          • Pierre Bulpa, MD
  • 沙特阿拉伯
      • Riyadh、沙特阿拉伯、14611
        • 招聘中
        • King Abdulaziz Medical City
        • 接触：
          • Yaseen Arabi, MD
  • 法国
      • Argenteuil、法国、95107
        • 主动，不招人
        • CH Argenteuil
      • Aurillac、法国、15000
        • 完全的
        • Centre Hospitalier Henri Mondor d'Aurillac
      • Beauvais、法国、60000
        • 主动，不招人
        • Beauvais General Hospital
      • Belfort、法国、90400
        • 暂停
        • Hopital Nord Franche-Comte
      • Boulogne-Billancourt、法国、92100
        • 招聘中
        • Ambroise Pare Hospital
        • 接触：
          • Antoine Vieillard Baron, MD
      • Béthune、法国、62660
        • 招聘中
        • Centre hospitalier Bethune Beuvry
        • 接触：
          • Christophe Vinsonneau, MD
      • Dax、法国、40100
        • 招聘中
        • CH de Dax
        • 接触：
          • Adrien Auvet, MD
      • Dieppe、法国、76202
        • 招聘中
        • Centre Hospitalier de Dieppe
        • 接触：
          • Peierre-Louis Declercq, MD
      • Dijon、法国、21000
        • 招聘中
        • CHU Dijon Bourgogne
        • 接触：
          • Jean-Pierre Quenot, MD
      • Eaubonne、法国、95600
        • 主动，不招人
        • Hopital Simone Veil Eaubonne
      • Garches、法国、92380
        • 招聘中
        • Hospital Raymond Poincare
        • 接触：
          • Djillali Annane, MD
      • La Roche-sur-Yon、法国、85000
        • 招聘中
        • CHD Vendee
        • 接触：
          • Gwenael Colin, MD
      • Le Mans、法国、72027
        • 招聘中
        • Centre Hospitalier Le Mans
        • 接触：
          • Christophe Guitton, MD
      • Limoges、法国、87000
        • 招聘中
        • CHU Dupuytren
        • 接触：
          • Francois Bruno, MD
      • Melun、法国、77000
        • 主动，不招人
        • Centre Hospitalier de Melun
      • Mont-de-Marsan、法国、40024
        • 招聘中
        • Centre Hospitalier Layne - Mont-de-Marsan
        • 接触：
          • Arnaud Sement, MD
      • Morlaix、法国、29600
        • 招聘中
        • Centre Hospitalier des Pays de Morlaix
        • 接触：
          • Pierre Yves Egreteau, MD
      • Orléans、法国、45100
        • 主动，不招人
        • CHR d'Orleans
      • Paris、法国、75010
        • 主动，不招人
        • Lariboisiere Hospital
      • Paris、法国、75020
        • 主动，不招人
        • Hopital Tenon
      • Strasbourg、法国、67200
        • 主动，不招人
        • Hopital de Hautepierre Strasbourg
      • Strasbourg、法国、67000
        • 招聘中
        • Nouvel Hopital Civil Strasbourg
        • 接触：
          • Ferhat Meziani, MD
      • Tours、法国、37000
        • 招聘中
        • CHRU Tours Hopital Bretonneau
        • 接触：
          • Emmanuelle Mercier, MD
      • Étampes、法国、91150
        • 主动，不招人
        • Sud Essonne Hospital Etampes
  • 澳大利亚
    • Australian Capital Territory
      • Canberra、Australian Capital Territory、澳大利亚、2605
        • 招聘中
        • Canberra Hospital
    • New South Wales
      • Bankstown、New South Wales、澳大利亚、2200
        • 招聘中
        • Bankstown-Lidcombe Hospital
      • Blacktown、New South Wales、澳大利亚、2148
        • 招聘中
        • Blacktown Hospital
      • Campbelltown、New South Wales、澳大利亚、2560
        • 招聘中
        • Campbelltown Hospital
      • Caringbah、New South Wales、澳大利亚、2229
        • 招聘中
        • Sutherland Hospital
      • Concord、New South Wales、澳大利亚、2139
        • 招聘中
        • Concord Hospital
      • Dubbo、New South Wales、澳大利亚、2830
        • 招聘中
        • Dubbo Base Hospital
      • Frenchs Forest、New South Wales、澳大利亚、2086
        • 招聘中
        • Northern Beaches Hospital
      • Kingswood、New South Wales、澳大利亚、2750
        • 招聘中
        • Nepean Hospital
      • Kogarah、New South Wales、澳大利亚、2217
        • 招聘中
        • St. George Hospital
      • Liverpool、New South Wales、澳大利亚、2170
        • 招聘中
        • Liverpool Hospital
      • Newcastle、New South Wales、澳大利亚、2305
        • 招聘中
        • John Hunter Hospital
      • Orange、New South Wales、澳大利亚、2800
        • 尚未招聘
        • Orange Health Service
      • Sydney、New South Wales、澳大利亚、2065
        • 招聘中
        • Royal North Shore Hospital
      • Sydney、New South Wales、澳大利亚、2010
        • 招聘中
        • St Vincent's Hospital Sydney
      • Sydney、New South Wales、澳大利亚、2031
        • 招聘中
        • Prince of Wales Hospital
      • Sydney、New South Wales、澳大利亚、2050
        • 尚未招聘
        • Royal Prince Alfred Hospital
      • Sydney、New South Wales、澳大利亚、2500
        • 招聘中
        • Wollongong Hospital
      • Wagga Wagga、New South Wales、澳大利亚、2650
        • 尚未招聘
        • Wagga Wagga Base Hospital
      • Westmead、New South Wales、澳大利亚、2145
        • 招聘中
        • Westmead Hospital
    • Northern Territory
      • Darwin、Northern Territory、澳大利亚、0810
        • 尚未招聘
        • Royal Darwin Hospital,
    • Queensland
      • Birtinya、Queensland、澳大利亚、4575
        • 尚未招聘
        • Sunshine Coast University Hospital
      • Brisbane、Queensland、澳大利亚、4102
        • 招聘中
        • Princess Alexandra Hospital
      • Brisbane、Queensland、澳大利亚、4032
        • 招聘中
        • The Prince Charles Hospital
      • Brisbane、Queensland、澳大利亚、4101
        • 招聘中
        • Mater Hospital Brisbane
      • Caboolture、Queensland、澳大利亚、4510
        • 招聘中
        • Caboolture Hospital
      • Coopers Plains、Queensland、澳大利亚、4110
        • 招聘中
        • Queen Elizabeth II Jubilee Hospital
      • Logan City、Queensland、澳大利亚、4129
        • 尚未招聘
        • Logan Hospital
      • Redcliffe、Queensland、澳大利亚、4020
        • 尚未招聘
        • Redcliffe Hospital
      • Rockhampton、Queensland、澳大利亚、4700
        • 尚未招聘
        • Rockhampton Hospital
      • Southport、Queensland、澳大利亚、4215
        • 招聘中
        • Gold Coast University Hospital
      • Toowoomba、Queensland、澳大利亚、4350
        • 招聘中
        • Toowoomba Hospital
      • Townsville、Queensland、澳大利亚、4814
        • 招聘中
        • Townsville Hospital
    • South Australia
      • Adelaide、South Australia、澳大利亚、5000
        • 招聘中
        • Royal Adelaide Hospital
      • Adelaide、South Australia、澳大利亚、5011
        • 招聘中
        • The Queen Elizabeth Hospital
      • Adelaide、South Australia、澳大利亚、5112
        • 招聘中
        • Lyell McEwin Hospital
      • Bedford Park、South Australia、澳大利亚、5042
        • 招聘中
        • Flinders Medical Centre
    • Tasmania
      • Launceston、Tasmania、澳大利亚、7250
        • 招聘中
        • Launceston Hospital
    • Victoria
      • Ballarat、Victoria、澳大利亚、3350
        • 招聘中
        • Ballarat Base Hospital
      • Bendigo、Victoria、澳大利亚、3550
        • 招聘中
        • Bendigo Hospital
      • Berwick、Victoria、澳大利亚、3806
        • 招聘中
        • Casey Hospital
      • Box Hill、Victoria、澳大利亚、3128
        • 招聘中
        • Box Hill Hospital
      • Clayton、Victoria、澳大利亚、3168
        • 招聘中
        • Monash Medical Centre
      • Dandenong、Victoria、澳大利亚、3175
        • 招聘中
        • Dandenong Hospital
      • Ferntree Gully、Victoria、澳大利亚、3156
        • 尚未招聘
        • Angliss Hospital
      • Footscray、Victoria、澳大利亚、3011
        • 招聘中
        • Footscray Hospital
      • Geelong、Victoria、澳大利亚、3220
        • 招聘中
        • University Hosptial Geelong
      • Melbourne、Victoria、澳大利亚、3004
        • 招聘中
        • The Alfred Hospital
      • Melbourne、Victoria、澳大利亚、3050
        • 招聘中
        • Royal Melbourne Hospital
      • Melbourne、Victoria、澳大利亚、3065
        • 招聘中
        • St Vincent's Hospital Melbourne
      • Ringwood East、Victoria、澳大利亚、3135
        • 招聘中
        • Maroondah Hospital
      • Sunshine、Victoria、澳大利亚、3021
        • 招聘中
        • Sunshine Hospital
      • Werribee、Victoria、澳大利亚、3030
        • 招聘中
        • Werribee Mercy Hospital
    • Western Australia
      • Midland、Western Australia、澳大利亚、6056
        • 招聘中
        • St John of God Hospital Midland
      • Murdoch、Western Australia、澳大利亚、6150
        • 尚未招聘
        • St John of God Hospital Murdoch
      • Perth、Western Australia、澳大利亚、6000
        • 招聘中
        • Royal Perth Hospital
      • Perth、Western Australia、澳大利亚、6150
        • 招聘中
        • Fiona Stanley Hospital
      • Perth、Western Australia、澳大利亚、6009
        • 招聘中
        • Sir Charles Gairdner Hospital
      • Subiaco、Western Australia、澳大利亚、6008
        • 招聘中
        • St John of God Subiaco
  • 爱尔兰
      • Cork、爱尔兰、T12 DC4A
        • 主动，不招人
        • Cork University Hospital
      • Dublin、爱尔兰
        • 招聘中
        • Beaumont Hospital
        • 接触：
          • Ger Curley, Prof.
      • Dublin、爱尔兰
        • 招聘中
        • St. Vincent's University Hospital
        • 接触：
          • Alistair Nichol, Prof.
      • Galway、爱尔兰
        • 招聘中
        • University Hospital Galway
        • 接触：
          • John Laffey, M.D.
      • Waterford、爱尔兰、X91 ER8E
        • 主动，不招人
        • University Hospital Waterford
  • 爱沙尼亚
      • Tartu、爱沙尼亚、50406
        • 暂停
        • Tartu University Hospital
  • 瑞士
      • Zurich、瑞士、8091
        • 暂停
        • University Hospital Zürich
  • 罗马尼亚
      • Bucharest、罗马尼亚、030303
        • 暂停
        • Clinical Hospital of Infectious and Tropical Diseases "Dr. Victor Babes"
  • 美国
    • Florida
      • Jacksonville、Florida、美国、32209
        • 招聘中
        • University of Florida
        • 接触：
          • Hadi Hatoum, MD
    • Georgia
      • Augusta、Georgia、美国、30912
        • 尚未招聘
        • Augusta University
        • 接触：
          • Jose Vazquez, MD
    • Illinois
      • Chicago、Illinois、美国、60612
        • 招聘中
        • University of Illinois Health
        • 接触：
          • Jeffrey Jacobson, MD
    • Louisiana
      • New Orleans、Louisiana、美国、70112
        • 尚未招聘
        • Tulane Medical Center
        • 接触：
          • Joshua Denson, MD
    • Michigan
      • Ann Arbor、Michigan、美国、48109
        • 招聘中
        • University of Michigan
        • 接触：
          • Robert Hyzy, MD
    • New York
      • New York、New York、美国、10065
        • 招聘中
        • Memorial Sloan Kettering Cancer Center
        • 接触：
          • Stephen Pastores, MD
    • North Carolina
      • Winston-Salem、North Carolina、美国、27157-1009
        • 尚未招聘
        • Wake Forest Baptist Health
        • 接触：
          • Ashish Khanna, MD
    • Ohio
      • Columbus、Ohio、美国、43210
        • 招聘中
        • The Ohio State University Wexner Medical Center
        • 接触：
          • Matthew Exline, MD
    • Oregon
      • Portland、Oregon、美国、97239-3098
        • 招聘中
        • Oregon Health and Science University
        • 接触：
          • Akram Khankhana, MD
    • Pennsylvania
      • Pittsburgh、Pennsylvania、美国
        • 招聘中
        • University of Pittsburgh Medical Centre
        • 接触：
          • Stephanie Mongomery
    • Rhode Island
      • Providence、Rhode Island、美国、02903
        • 尚未招聘
        • Brown University - Rhode Island Hospital
        • 接触：
          • Mitchell Levy, MD
  • 芬兰
      • Helsinki、芬兰、00290
        • 暂停
        • Helsinki University Hospital
      • Tampere、芬兰、33520
        • 暂停
        • Tampere University Hospital
  • 英国
      • Belfast、英国、BT16 1RH
        • 招聘中
        • Ulster Hospital
        • 接触：
          • Christopher Murray, MD
      • Bristol、英国、BS2 8BJ
        • 招聘中
        • Bristol Royal Childrens Hospital
        • 接触：
          • Jolanta Bernatoniene, MD
      • Bury、英国、BL9 7TD
        • 招聘中
        • Fairfield General Hospital
        • 接触：
          • Andrew Claxton, MD
      • Crewe、英国、CW1 4QJ
        • 招聘中
        • Leighton Hospital
        • 接触：
          • Richard Lowsby, MD
      • Dorchester、英国、DT1 2JY
        • 完全的
        • Dorset County Hospital
      • Gloucester、英国、GL1 3NN
        • 完全的
        • Gloucester Royal Hospital
      • Haywards Heath、英国、RH16 4EX
        • 主动，不招人
        • The Princess Royal Hospital Haywards Heath
      • Leeds、英国、LS9 7TF
        • 招聘中
        • St. James University Hospital
        • 接触：
          • E Paramasivam, MD
      • London、英国、NW1 2BU
        • 招聘中
        • University College London Hospital
        • 接触：
          • Michael Marks, MD
      • London、英国、SW10 9NH
        • 招聘中
        • Chelsea and Westminster Hospital
        • 接触：
          • Roger Davies, MD
      • London、英国、E9 6SR
        • 暂停
        • Homerton Hospital
      • Margate、英国、CT9 4AN
        • 暂停
        • Queen Elizabeth and Queen Mother Hospital
      • Newcastle upon Tyne、英国、NE1 4LP
        • 招聘中
        • Newcastle Royal Victoria Infirmary (Paediatrics)
        • 接触：
          • Marieke Emonts, MD
      • North Shields、英国、Ne29 8NH
        • 暂停
        • North Tyneside General Hospital
      • Warwick、英国、CV34 5BW
        • 主动，不招人
        • Warwick Hospital
      • West Bromwich、英国、B71 4HJ
        • 招聘中
        • Sandwell General Hospital
        • 接触：
          • Jonathan Hulme, MD
    • England
      • Basildon、England、英国、SS16 5NL
        • 主动，不招人
        • Basildon Hospital
      • Basingstoke、England、英国、RG24 9NA
        • 招聘中
        • Basingstoke and North Hampshire Hospital
        • 接触：
          • Irena Grecu, MD
      • Bath、England、英国、BA1 3NG
        • 主动，不招人
        • Royal United Hospital, Bath
      • Birmingham、England、英国、B15 2TH
        • 招聘中
        • Queen Elizabeth Hospital Birmingham
        • 接触：
          • Dhruv Parekh
      • Birmingham、England、英国、B18 7QH
        • 招聘中
        • Birmingham City Hospital
        • 接触：
          • Jonathan Hulme
      • Blackburn、England、英国、BB2 3HH
        • 招聘中
        • Royal Blackburn Teaching Hospital
        • 接触：
          • Srikanth Chukkambotla, MD
      • Boston、England、英国、PE21 9QS
        • 暂停
        • Pilgrim Hospital ULHT
      • Bournemouth、England、英国、BH7 7DW
        • 主动，不招人
        • Royal Bournemouth Hospital
      • Brighton、England、英国、BN2 5BE
        • 暂停
        • Royal Sussex County Hospital
      • Bristol、England、英国、BS10 5NB
        • 暂停
        • Southmead Hospital
      • Bristol、England、英国、BS2 8EX
        • 主动，不招人
        • Bristol Royal Infirmary
      • Burton-on-Trent、England、英国、DE13 0RB
        • 主动，不招人
        • Queen's Hospital, Burton
      • Cambridge、England、英国、CB2 0AY
        • 主动，不招人
        • Royal Papworth Hospital
      • Cambridge、England、英国、CB2 0QQ
        • 主动，不招人
        • Addenbrookes Hospital
      • Carlisle、England、英国、CA2 7HY
        • 暂停
        • North Cumberland Infirmary
      • Chertsey、England、英国、KT16 0P
        • 主动，不招人
        • St Peter's Hospital
      • Chester、England、英国、CH2 1UL
        • 主动，不招人
        • Countess of Chester Hospital
      • Chesterfield、England、英国、S44 5BL
        • 招聘中
        • Chesterfield Royal Hospital
        • 接触：
          • Euan Mackay
      • Colchester、England、英国、CO4 5JL
        • 招聘中
        • Colchester Hospital
        • 接触：
          • Mohamed Ramali
      • Coventry、England、英国、CV2 2DX
        • 主动，不招人
        • University Hospital Coventry
      • Darlington、England、英国、DL3 6HX
        • 暂停
        • Darlington Memorial Hospital
      • Dartford、England、英国、DA2 8DA
        • 撤销
        • Darent Valley Hospital
      • Dudley、England、英国、DY1 2HQ
        • 主动，不招人
        • Russells Hall Hospital
      • Exeter、England、英国、Ex2 5DW
        • 暂停
        • Royal Devon and Exeter Hospital
      • Frimley、England、英国、GU16 7 UJ
        • 暂停
        • Frimley Park Hospital
      • Gateshead、England、英国、NE9 6SX
        • 主动，不招人
        • Queen Elizabeth Hospital Gateshead
      • Gillingham、England、英国、ME7 5NY
        • 完全的
        • Medway Maritime Hospital
      • Great Yarmouth、England、英国、NR31 6LA
        • 完全的
        • James Paget University Hospital
      • Guildford、England、英国、GU2 7XX
        • 招聘中
        • Royal Surrey County Hospital
        • 接触：
          • Ben Creagh-Brown
      • Harrow、England、英国、HA1 3UJ
        • 主动，不招人
        • Northwick Park Hospital
      • Hereford、England、英国、HR1 2ER
        • 招聘中
        • Hereford County Hospital
        • 接触：
          • Charlotte Small
      • High Barnet、England、英国、EN5 3DJ
        • 主动，不招人
        • Barnet Hospital
      • Huddersfield、England、英国、HD3 3EA
        • 主动，不招人
        • Huddersfield Royal Infirmary
      • Ilford、England、英国、IG3 8YB
        • 主动，不招人
        • King George Hospital
      • Ipswich、England、英国、IP4 5PD
        • 撤销
        • Ipswich Hospital
      • Kettering、England、英国、NN16 8UZ
        • 招聘中
        • Kettering Hospital
        • 接触：
          • Dhinesh Sundaran
      • Leeds、England、英国、LS9 7TF
        • 主动，不招人
        • Leeds General Infirmary
      • Leicester、England、英国、LE1 5WW
        • 暂停
        • Leicester Royal Infirmary
      • Leicester、England、英国、LE3 9QP
        • 暂停
        • Glenfield Hospital
      • Lincoln、England、英国、LN2 5QY
        • 暂停
        • Lincoln County Hospital
      • Liverpool、England、英国、L7 8XP
        • 主动，不招人
        • Royal Liverpool University Hospital
      • Liverpool、England、英国、L14 3PE
        • 完全的
        • Liverpool Heart and Chest Hospital
      • Liverpool、England、英国、L14 5AB
        • 完全的
        • Alder Hey Hospital
      • Liverpool、England、英国、L9 7AL
        • 暂停
        • University Hospital Aintree
      • London、England、英国、SE5 9RS
        • 招聘中
        • King's College Hospital
        • 接触：
          • Phillip Hopkins
      • London、England、英国、W12 0HS
        • 招聘中
        • Hammersmith Hospital
        • 接触：
          • Stephen Brett
      • London、England、英国、W2 1NY
        • 招聘中
        • St Mary's Hospital
        • 接触：
          • Anthony Gordon
      • London、England、英国、W6 8RF
        • 招聘中
        • Charing Cross Hospital
        • 接触：
          • David Antcliffe
      • London、England、英国、CR7 7YE
        • 主动，不招人
        • Croydon University Hospital
      • London、England、英国、E1 1FR
        • 主动，不招人
        • Royal London Hospital
      • London、England、英国、E11 1NR
        • 主动，不招人
        • Whipps Cross Hospital
      • London、England、英国、E13 8SL
        • 主动，不招人
        • Newham University Hospital
      • London、England、英国、EC1A 7BE
        • 主动，不招人
        • St Bartholomew's Hospital
      • London、England、英国、N18 1QX
        • 主动，不招人
        • North Middlesex University Hospital
      • London、England、英国、NW3 2QG
        • 主动，不招人
        • Royal Free Hospital
      • London、England、英国、SE1 7EH
        • 招聘中
        • St Thomas Hospital
        • 接触：
          • Marlies Ostermann
      • London、England、英国、SE1 9RT
        • 主动，不招人
        • Guy's Hospital
      • London、England、英国、SE18 4QH
        • 主动，不招人
        • Queen Elizabeth Hospital, Woolwich
      • London、England、英国、SW3 6JJ
        • 主动，不招人
        • Royal Marsden Hospital
      • London、England、英国、SW3 6NP
        • 主动，不招人
        • Royal Brompton Hospital
      • London、England、英国、SW17 0QT
        • 招聘中
        • St George's University Hospital
        • 接触：
          • Susannah Leaver
      • Luton、England、英国、LU4 0DZ
        • 暂停
        • Luton and Dunstable University Hospital
      • Maidstone、England、英国、ME16 9QQ
        • 招聘中
        • Maidstone Hospital
        • 接触：
          • David Golden, MD
      • Manchester、England、英国、M13 9WL
        • 暂停
        • Manchester Royal Infirmary
      • Manchester、England、英国、M20 4BX
        • 完全的
        • The Christie Hospital
      • Manchester、England、英国、M23 9LT
        • 暂停
        • Wythenshawe Hospital
      • Manchester、England、英国、M8 5RB
        • 主动，不招人
        • North Manchester General Hospital
      • Metropolitan Borough of Wirral、England、英国、CH49 5PE
        • 招聘中
        • Arrowe Park Hospital
        • 接触：
          • Craig Denmade, MD
      • Middlesbrough、England、英国、TS4 3BW
        • 招聘中
        • The James Cook University Hospital
        • 接触：
          • Jeremy Henning, MD
      • Milton Keynes、England、英国、MK6 5LD
        • 招聘中
        • Milton Keynes University Hospital
        • 接触：
          • Richard Stewart, MD
      • Newcastle、England、英国、NE1 4LP
        • 暂停
        • Royal Victoria Infirmary, Newcastle
      • Newcastle、England、英国、NE7 7DN
        • 暂停
        • Newcastle Freeman Hospital
      • Northampton、England、英国、NN1 5BD
        • 暂停
        • Northampton General Hospital
      • Norwich、England、英国、NR4 7UY
        • 完全的
        • Norfolk and Norwich University Hospital
      • Nottingham、England、英国、NG5 1PB
        • 招聘中
        • City Hospital Nottingham
        • 接触：
          • Daniel Harvey, MD
      • Nottingham、England、英国、NG7 2UH
        • 招聘中
        • Queen's Medical Centre - Nottingham University Hospitals NHS Trust
        • 接触：
          • Daniel Harvey, MD
      • Nuneaton、England、英国、CV10 7DJ
        • 主动，不招人
        • George Eliot Hospital
      • Oldham、England、英国、Ol1 2JH
        • 招聘中
        • Royal Oldham Hospital
        • 接触：
          • Redmond Tully, MD
      • Orpington、England、英国、BR6 8ND
        • 暂停
        • Princess Royal University Hospital
      • Oxford、England、英国、OX3 9DU
        • 主动，不招人
        • John Radcliffe Hospital
      • Plymouth、England、英国、PL6 8DH
        • 招聘中
        • Derriford Hospital
        • 接触：
          • Nikitas Nikitas, MD
      • Poole、England、英国、BH15 2JB
        • 招聘中
        • Poole Hospital NHS Foundation Trust
        • 接触：
          • Henrik Reschreiter, MD
      • Portsmouth、England、英国、PO6 3LY
        • 招聘中
        • Queen Alexandra Hospital
        • 接触：
          • David Pogson, MD
      • Prescot、England、英国、L35 5DR
        • 终止
        • Whiston Hospital
      • Preston、England、英国、PR2 9HT
        • 暂停
        • Royal Preston Hospital
      • Reading、England、英国、RG1 5AN
        • 招聘中
        • Royal Berkshire Hospital
        • 接触：
          • Andrew Walden, MD
      • Redditch、England、英国、B98 7UB
        • 主动，不招人
        • Alexandra Hospital, Redditch
      • Romford、England、英国、RM7 0AG
        • 主动，不招人
        • Queen's Hospital Romford
      • Rotherham、England、英国、S60 2UD
        • 招聘中
        • Rotherham Hospital
        • 接触：
          • Anil Hormis, MD
      • Royal Tunbridge Wells、England、英国、TN2 4QJ
        • 招聘中
        • Tunbridge Wells Hospital - Maidstone and Tunbridge Wells NHS Trust
        • 接触：
          • David Golden, MD
      • Salford、England、英国、M6 8HD
        • 招聘中
        • Salford Royal Hospital
        • 接触：
          • Paul Dark, MD
      • Salisbury、England、英国、SP2 8BJ
        • 招聘中
        • Salisbury District Hospital
        • 接触：
          • Phil Donnison, MD
      • Sheffield、England、英国、S10 2JF
        • 招聘中
        • Royal Hallamshire Hospital
        • 接触：
          • Gary Mills, MD
      • Sheffield、England、英国、S5 7AU
        • 招聘中
        • Northern General Hospital
        • 接触：
          • Gary Mills, MD
      • Slough、England、英国、SL2 4HL
        • 主动，不招人
        • Wexham Park Hospital
      • South Shields、England、英国、NE34 0PL
        • 招聘中
        • South Tyneside District Hospital
        • 接触：
          • Alistair Roy, MD
      • Southampton、England、英国、SO16 6YD
        • 招聘中
        • Southampton General Hospital
        • 接触：
          • Ahilanandan Dushianthan, MD
      • Stockport、England、英国、SK2 7JE
        • 招聘中
        • Stepping Hill Hospital
        • 接触：
          • Hywel Garrard, MD
      • Stockton-on-Tees、England、英国、TS19 8PE
        • 招聘中
        • University Hospital of North Tees
        • 接触：
          • Farooq Brohi, MD
      • Stoke-on-Trent、England、英国、ST4 6QG
        • 招聘中
        • Royal Stoke University Hospital
        • 接触：
          • Ramprasad Matsa, MD
      • Sunderland、England、英国、SR4 7TP
        • 招聘中
        • Sunderland Royal Hospital
        • 接触：
          • Alistair Roy, MD
      • Sutton in Ashfield、England、英国、NG17 4JL
        • 招聘中
        • King's Mill Hospital
        • 接触：
          • Sandaruwan Herath, MD
      • Swindon、England、英国、SN3 6BB
        • 招聘中
        • Western General Hospital
        • 接触：
          • Jonathan Rhodes, MD
      • Swindon、England、英国、SN3 6BB
        • 主动，不招人
        • Great Western Hospital
      • Taunton、England、英国、TA1 5DA
        • 招聘中
        • Musgrove Park Hospital
        • 接触：
          • Richard Innes, MD
      • Torquay、England、英国、TQ2 7AA
        • 招聘中
        • Torbay Hospital
        • 接触：
          • Adam Revill, MD
      • Truro、England、英国、TR1 3LJ
        • 招聘中
        • Royal Cornwall Hospital
        • 接触：
          • Michael Spivey, MD
      • Uxbridge、England、英国、UB9 6JH
        • 完全的
        • Harefield Hospital
      • Watford、England、英国、WD18 0HB
        • 招聘中
        • Watford General Hospital
        • 接触：
          • Valarie Page, MD
      • Westcliff-on-Sea、England、英国、ISS0 0RY
        • 主动，不招人
        • Southend Hospital
      • Whitehaven、England、英国、CA28 8JG
        • 撤销
        • West Cumberland Hospital
      • Wigan、England、英国、WN1 2NN
        • 主动，不招人
        • Royal Albert Edward Infirmary
      • Winchester、England、英国、SO22 5DG
        • 招聘中
        • Royal Hampshire County Hospital
        • 接触：
          • Irina Grecu, MD
      • Wolverhampton、England、英国、WV10 0QP
        • 主动，不招人
        • New Cross Hospital Wolverhampton
      • Worcester、England、英国、WR5 1DD
        • 主动，不招人
        • Worcestershire Royal Hospital
      • York、England、英国、Y031 8HE
        • 招聘中
        • York Teaching Hospital
        • 接触：
          • Joseph Carter, MD
    • Northern Ireland
      • Antrim、Northern Ireland、英国、BT41 2RL
        • 招聘中
        • Antrim Area Hospital
        • 接触：
          • Paul Johnston, MD
      • Belfast、Northern Ireland、英国、BT14 6AB
        • 招聘中
        • Mater Hospital
        • 接触：
          • Michael McGinlay, MD
      • Belfast、Northern Ireland、英国、BT9 7AB
        • 招聘中
        • Belfast City Hospital
        • 接触：
          • Michael McGinlay, MD
      • Belfast、Northern Ireland、英国、BT12 6BA
        • 招聘中
        • Royal Victoria Hospital Belfast
        • 接触：
          • Michael McGinlay, MD
      • Londonderry、Northern Ireland、英国、BT47 6SB
        • 招聘中
        • Altnagelvin Hospital
        • 接触：
          • Adrian Donnelly, MD
    • Scotland
      • Aberdeen、Scotland、英国、AB25 2ZN
        • 完全的
        • Aberdeen Royal Infirmary
      • Dundee、Scotland、英国、DD1 9SY
        • 招聘中
        • Ninewells Hospital
        • 接触：
          • James Chambers, MD
      • Edinburgh、Scotland、英国、EH16 4SA
        • 招聘中
        • Royal Infirmary of Edinburgh
        • 接触：
          • Thomas Craven, MD
      • Glasgow、Scotland、英国、G4 0SF
        • 招聘中
        • Glasgow Royal Infirmary
        • 接触：
          • Kathryn Puxty, MD
      • Glasgow、Scotland、英国、G51 4TF
        • 招聘中
        • Queen Elizabeth University Hospital, Glasgow
        • 接触：
          • Malcolm Sim, MD
      • Paisley、Scotland、英国、PA2 9PN
        • 招聘中
        • Royal Alexandra Hospital
        • 接触：
          • Kevin Rooney, MD
    • Wales
      • Abergavenny、Wales、英国、NP7 7EG
        • 主动，不招人
        • Neville Hall Hospital
      • Bodelwyddan、Wales、英国、LL18 5UJ
        • 主动，不招人
        • Glan Clwyd Hospital
      • Bridgend、Wales、英国、CF31 1RQ
        • 主动，不招人
        • Princess of Wales Hospital
      • Cardiff、Wales、英国、CF14 4XW
        • 主动，不招人
        • Cardiff and Vale University Hospital Wales
      • Carmarthen、Wales、英国、SA31 2AF
        • 暂停
        • Glangwilli Hospital
      • Cwmbran、Wales、英国、NP44 8YN
        • 主动，不招人
        • Grange University Hospital
      • Newport、Wales、英国、NP20 2UB
        • 暂停
        • Royal Gwent Hospital
      • Pont-y-clun、Wales、英国、CF72 8XR
        • 主动，不招人
        • Royal Glamorgan Hospital
      • Swansea、Wales、英国、SA6 6NL
        • 主动，不招人
        • Morriston Hospital
      • Wrexham、Wales、英国、LL13 7TD
        • 招聘中
        • Wrexham Maelor Hospital
        • 接触：
          • David Southern, MD
  • 荷兰
      • 's-Hertogenbosch、荷兰
        • 招聘中
        • Jeroen Bosch Ziekenhuis
        • 接触：
          • Koen Simons, M.D.
      • Almelo、荷兰、7609PP
        • 招聘中
        • ZGT Almelo
        • 接触：
          • Bastiaan Wittekamp, MD
      • Amersfoort、荷兰
        • 招聘中
        • Meander Medisch Centrum
        • 接触：
          • Laura van Gulik, M.D.
      • Amsterdam、荷兰、1091AC
        • 主动，不招人
        • OLVG
      • Arnhem、荷兰、6815AD
        • 招聘中
        • Rijnstate Hospital
        • 接触：
          • Robert-Jan Hassing, MD
      • Deventer、荷兰、7416SE
        • 主动，不招人
        • Deventer Hospital
      • Ede、荷兰、6716RP
        • 主动，不招人
        • Ziekenhuis Gelderse Vallei
      • Eindhoven、荷兰、5631BM
        • 主动，不招人
        • Maxima Medisch Centrum Eindhoven
      • Groningen、荷兰
        • 撤销
        • Martini Hospital Groningen
      • Groningen、荷兰
        • 主动，不招人
        • University Medical Center Groningen
      • Leeuwarden、荷兰、8934AD
        • 主动，不招人
        • Medisch Centrum Leeuwarden
      • Leiden、荷兰
        • 招聘中
        • Leiden University Medical Center
        • 接触：
          • Evert De Jonge, Prof.
      • Nijmegen、荷兰
        • 招聘中
        • Radboud University Medical Center
        • 接触：
          • Frank van de Veerdonk, Prof.
      • Nijmegen、荷兰
        • 招聘中
        • Canisius Wilhelmina Ziekenhuis
        • 接触：
          • Oscar Hoiting, M.D.
      • Roermond、荷兰、6043CV
        • 主动，不招人
        • Laurentius Hospital
      • Rotterdam、荷兰、3079DZ
        • 招聘中
        • Maasstad Ziekenhuis
        • 接触：
          • Corstiaan den Uil, MD
      • The Hague、荷兰、2545AA
        • 招聘中
        • Hagaziekenhuis
        • 接触：
          • Thomas Ottens, MD
      • Uden、荷兰、5406PT
        • 主动，不招人
        • Bernhoven Hospital
    • Utrecht
      • Utrecht、Utrecht、荷兰、3584 CX
        • 招聘中
        • University Medical Center Utrecht
        • 接触：
          • Marc Bonten, Prof.
        • 接触：
          • Lennie Derde, MD
  • 葡萄牙
      • Abrantes、葡萄牙
        • 招聘中
        • Centro Hospitalar do Medio Tejo
        • 接触：
          • Nuno Catorze, M.D.
      • Lisbon、葡萄牙、1169-050
        • 暂停
        • Hospital Ocidental
      • Lisbon、葡萄牙
        • 暂停
        • Hospital Lusíadas Lisbon
  • 西班牙
      • Barcelona、西班牙
        • 招聘中
        • Hospital del Mar
        • 接触：
          • Rosana Munoz-Bermúdez, M.D.
      • Cadiz、西班牙、11407
        • 招聘中
        • Hospital Universitario de Jerez
        • 接触：
          • Ángel Estella, MD
      • Córdoba、西班牙、14004
        • 招聘中
        • Reina Sofia University Hospital
        • 接触：
          • Eduardo Aguilar Alonso, M.D.
      • Madrid、西班牙、28034
        • 招聘中
        • Ramon y Cajal University Hospital
        • 接触：
          • Cruz Soriano, MD
      • Málaga、西班牙、29010
        • 招聘中
        • Hospital Regional de Málaga
        • 接触：
          • Manuel Herrera Gutiérrez, MD
      • Ourense、西班牙、32005
        • 招聘中
        • Hospital Universitario de Ourense
        • 接触：
          • Pablo Vidal, MD
      • Santander、西班牙、39008
        • 招聘中
        • Hospital Marqués de Valdecilla
        • 接触：
          • Borja Suberviola, MD
      • Tortosa、西班牙、43500
        • 招聘中
        • Hospital Verge de la Cinta
        • 接触：
          • Ferran Roche Campo, MD
      • Valencia、西班牙、46026
        • 招聘中
        • Hospital La Fe
        • 接触：
          • Paula Ramírez, MD
      • Valencia、西班牙、46017
        • 招聘中
        • Doctor Peset University Hospital
        • 接触：
          • Rafael Zaragoza, MD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

4周 及以上 (孩子、成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

The eligibility criteria for the Platform are applied at multiple levels. One level is that there are inclusion and exclusion criteria that determine eligibility for randomization within the Platform. Another level is that, once eligible for inclusion within the Platform, additional criteria (typically exclusion criteria) are applied that are specific to each domain. Finally, intervention-level eligibility criteria may be applied for interventions within a domain. A patient is eligible for inclusion within a domain when:

  • All Platform inclusion criteria are met
  • None of the Platform exclusion criteria are met
  • Domain-specific eligibility criteria are met
  • The patient is eligible for at least two interventions within a domain

As such, the key "inclusion criteria" for being eligible for a domain are that the patient is eligible for the Platform.

--

PLATFORM INCLUSION CRITERIA:

  1. Hospitalised patient
  2. Acute respiratory tract infection
  3. Aged 28 days or older

PLATFORM EXCLUSION CRITERIA:

  1. Death is deemed to be imminent and inevitable during the next 24 hours AND one or more of the patient, substitute decision maker or attending physician are not committed to full active treatment
  2. Patient is expected to be discharged from hospital within the next 24 hours
  3. Previous participation in this REMAP within the last 90 days

DOMAIN-SPECIFIC ELIGIBILITY CRITERIA:

Each domain may have additional eligibility criteria. Refer to the study website for more information (www.remapcap.org).

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：阶乘赋值
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
其他：Antibiotic Domain

Patients with community-acquired pneumonia and requiring empiric antibiotic therapy will be randomised one of five antibiotic interventions.

Note: the ceftaroline + macrolide intervention has been closed to recruitment.
药品：Ceftriaxone + Macrolide

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

药品：Moxifloxacin or Levofloxacin

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

药品：Piperacillin-tazobactam + Macrolide

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

药品：Ceftaroline + Macrolide

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

Note: this intervention is now closed.

药品：Amoxicillin-clavulanate + Macrolide

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.
其他：Macrolide Duration Domain

Patients with community-acquired pneumonia who have been allocated to receive a beta-lactam + macrolide intervention in the Antibiotic Domain will be randomised to either a standard course or extended course of macrolide therapy
药品：Standard course macrolide

Standard course of macrolide therapy, discontinued between study day 3 and the end of study day 5.

The dosing of and route of administration is not protocolised, the following guidance is provided:

  • Initial IV administration of a macrolide is strongly preferred
  • The preferred IV macrolide is azithromycin, but IV clarithromycin may be substituted.
  • The preferred enteral macrolide is azithromycin, but enteral clarithromycin or roxithromycin may be substituted.
药品：Extended course macrolide

Extended course of macrolide therapy discontinued at the end of study day 14 or hospital discharge (whichever occurs first).

The dosing of and route of administration is not protocolised, the following guidance is provided:

  • Initial IV administration of a macrolide is strongly preferred
  • The preferred IV macrolide is azithromycin, but IV clarithromycin may be substituted.
  • The preferred enteral macrolide is azithromycin, but enteral clarithromycin or roxithromycin may be substituted.
其他：Corticosteroid Domain

Patients with severe lower-respiratory tract infection will be randomised to a steroid use strategy.

Note: this domain is now closed to patients with suspected or proven COVID-19. It remains open to patients with CAP without COVID-19.

Note: the fixed-course hydrocortisone has been closed to recruitment
其他：No systemic corticosteroid

Patients are not to receive any systemic corticosteroids, including hydrocortisone, to study day 28 or hospital discharge (whichever occurs first).

药品：Fixed-duration Hydrocortisone

50mg of intravenous hydrocortisone will be administered every 6 hours for up to 7 days.

Note: this intervention is now closed.

药品：Shock-dependent hydrocortisone

50mg IV hydrocortisone every 6 hours while the patient is in septic shock

药品：Fixed-duration higher dose Hydrocortisone

100mg of intravenous hydrocortisone will be administered every 6 hours for up to 7 days.

Note: this intervention was only available to patients with suspected or proven COVID-19 and is now closed.

药品：Fixed-duration dexamethasone

6 mg of IV or enteral dexamethasone will be administered daily for up to 10 days while in hospital.
其他：Influenza Antiviral Domain

Patients with microbiological testing confirmed influenza infection will be randomised to one of six interventions.
其他：No antiviral agent for influenza

No antiviral agent intended to be active against influenza infection is to be administered

药品：Five-days oseltamivir

Oseltamivir administered enterally twice daily for 5 days or until hospital discharge (whichever occurs first)

药品：Ten-days oseltamivir

Oseltamivir administered enterally twice daily for 10 days or until hospital discharge (whichever occurs first)

药品：Baloxavir Marboxil

Baloxavir marboxil administered on days 1 and 4 post-randomisation.

药品：Five-days oseltamivir + baloxavir marboxil

Oseltamivir administered enterally twice daily for 5 days or until hospital discharge (whichever occurs first), in addition to baloxavir marboxil administered on days 1 and 4 post-randomisation.

药品：Ten-days oseltamivir + baloxavir marboxil

Oseltamivir administered enterally twice daily for 10 days or until hospital discharge (whichever occurs first), in addition to baloxavir marboxil administered on days 1 and 4 post-randomisation.
其他：COVID-19 Antiviral Domain

Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to no ivermectin or ivermectin.

Note: an earlier version of this domain evaluated lopinavir-ritonavir, hydroxychloroquine, and combination lopinavir-ritonavir and hydroxychloroquine against a 'no antiviral' control.

This domain is now closed.
其他：No antiviral agent for COVID-19

No antiviral agent intended to be active against SARS-CoV-2 infection is to be administered

药品：Lopinavir / Ritonavir

Lopinavir/ritonavir 400/100mg administered enterally, or 5ml 80/20mg per mL solution suspension via gastric tube, every 12 hours. Administered for a minimum of 5 days, including if discharged from ICU prior to end of study day 5. For patients discharged from ICU between study day 6 and study day 14, lopinavir/ritonavir is ceased at ICU discharge. Lopinavir/ritonavir is ceased at the end of study day 14 if the patient remains in ICU.

Note: this intervention is now closed.

药品：Hydroxychloroquine

Loading dose of 800mg hydroxychloroquine administered enterally every 6 hours until 2 doses have been administered. Subsequently, 400mg hydroxychloroquine will be administered enterally every 12 hours for 12 doses or ICU discharge (whichever occurs first).

Note: this intervention is now closed.

药品：Hydroxychloroquine + lopinavir/ritonavir

Lopinavir/ritonavir 400/100mg administered enterally, or 5ml 80/20mg per mL solution suspension via gastric tube, every 12 hours. Administered for a minimum of 5 days, including if discharged from ICU prior to end of study day 5. For patients discharged from ICU between study day 6 and study day 14, lopinavir/ritonavir is ceased at ICU discharge. Lopinavir/ritonavir is ceased at the end of study day 14 if the patient remains in ICU.

Loading dose of 800mg hydroxychloroquine administered enterally every 6 hours until 2 doses have been administered. Subsequently, 400mg hydroxychloroquine will be administered enterally every 12 hours for 12 doses or ICU discharge (whichever occurs first).

Note: this intervention is now closed.

药品：Ivermectin

Ivermectin administered enterally at a dose of 0.2 mg/kg once daily with a maximum daily dose of 24mg/day.

Note: this intervention is now closed.
其他：COVID-19 Immune Modulation Domain

Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to one of up to five interventions.

Note: this domain is now closed.
其他：No immune modulation for COVID-19

No immune modulating agent intended to be active against COVID-19 is to be administered.

Note: this intervention is now closed.

药品：Interferon beta-1a

IFN-β1a 10 μg will be administered as an intravenous bolus injection via a central or peripheral line. IFN-β1a will be administered once daily for 6 days or until ICU discharge, whichever occurs first.

Note: this intervention is now closed.

其他名称：
  • 干扰素-β1a
药品：Anakinra

A loading dose of 300mg anakinra will be administered as a bolus via central or peripheral line. This is followed by maintenance doses of 100mg of anakinra administered every 6 hours.

In patients with renal impairment, anakinra will be administered on alternate days.

Note: this intervention is now closed.

药品：Tocilizumab

Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg.

Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period.

Note: this intervention is now closed.

药品：Sarilumab

Sarilumab will be administered as a single dose of 400mg, via IV infusion through peripheral or central line over a one-hour period.

Note: this intervention is now closed.

药品：Tocilizumab

Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg. In children weighing less than 30kg, tocilizumab dose will be 12mg/kg.

Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period.
其他：Anticoagulation Domain

Patients admitted to participating intensive care units with suspected or microbiological testing confirmed COVID-19 will be randomised to an anticoagulation strategy.

Note: A previous version of this domain evaluated local standard venous thromboprophylaxis against therapeutic dose anticoagulation. This domain is now closed.
药品：Local standard venous thromboprophylaxis

Standard venous thromboprophylaxis that complies with local guidelines or usual practice will be administered for 14 days following randomisation or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.

药品：Therapeutic dose anticoagulation

Patients will be administered either low molecular weight heparin (LMWH) or unfractionated heparin (UFH) to achieve systemic anticoagulation. Either agent may be used and the same patient may be switched between UFH and LMWH at the discretion of the treating clinician.

Note: this intervention is now closed.

药品：Conventional low dose thromboprophylaxis

Low dose thromboprophylaxis will be administered for 14 days following randomisation or until hospital discharge, whichever occurs first. Dosing is outlined in the relevant protocol documents for this domain.

药品：Intermediate dose thromboprophylaxis

Intermediate dose thromboprophylaxis will be administered for 14 days following randomisation or until hospital discharge, whichever occurs first. Dosing is outlined in the relevant protocol documents for this domain.

药品：Continuation of therapeutic dose anticoagulation

Patients already receiving therapeutic dose anticoagulation at the time of randomisation to this intervention will be administered either unfractionated heparin by IV infusion or low-molecular weight heparin to achieve systemic anticoagulation according to local practice for acute VTE treatment for 14 days following randomisation or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.
其他：Immunoglobulin Domain

Immunosuppressed patients admitted to participating hospitals with microbiological testing confirmed COVID-19 will be randomised to receive no immunoglobulin for COVID-19, or to receive high-titre convalescent plasma.

Note: an earlier version of this domain was not restricted to immunosuppressed patients.
其他：No immunoglobulin

No immunoglobulin intended to be active against SARS-CoV-2 infection is to be administered.

生物：Convalescent plasma

Patients will receive at least one and no more than two units of ABO compatible convalescent plasma within 48 hours of randomisation.

生物：Delayed administration of convalescent plasma

Note: this intervention is now closed.
其他：Vitamin C Domain

Patients admitted to participating hospitals with community-acquired pneumonia will be randomised to receive no vitamin C, or vitamin C.

Note: this domain is now closed.
其他：No vitamin C

No high dose intravenous vitamin C is to be administered

Note: this intervention is now closed.

药品：Vitamin C

Intravenous Vitamin C 50mg/kg administered every 6 hours for 16 doses

Note: this intervention is now closed.
其他：Simvastatin Domain

Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to receive no simvastatin, or simvastatin.

Note: this domain is now closed.
其他：No simvastatin

No simvastatin intended to be active against COVID-19 is to be administered

Note: this intervention is now closed.

药品：Simvastatin

Simvastatin 80mg administered once daily via enteral route, while the patient remains in hospital up to 28 days after randomisation

Note: this intervention is now closed.
其他：Antiplatelet Domain

Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to receive no antiplatelet, aspirin, or site-preferred P2Y12 inhibitor.

Note: this domain is now closed.
其他：No antiplatelet

No antiplatelet agent or NSAID to be administered.

Note: this intervention is now closed.

药品：Aspirin

Aspirin administered at either 75mg or 100mg once per day for 14 days or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.

其他名称：
  • 乙酰水杨酸
药品：P2Y12 inhibitor

Site-selected P2Y12 inhibitor:

  • Clopidogrel: administered 75 mg once per day for 14 days or until hospital discharge, whichever occurs first.
  • Prasugrel: If patient is aged less than 75 years and measured or estimated weight if 60kg or more, and initial loading dose of prasugrel 60 mg will be administered, followed by maintenance dose of 10 mg per day.
  • Ticagrelor: administered enterally at 60mg twice daily for 14 days or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.

其他名称：
  • 普拉格雷
  • 氯吡格雷
  • 替格瑞洛
其他：Mechanical Ventilation Domain

Patients with community-acquired pneumonia admitted to participating intensive care units who are intubated and receiving invasive mechanical ventilation will be randomised to protocolised mechanical ventilation strategy, or clinician-preferred mechanical ventilation strategy
程序：Clinician-preferred mechanical ventilation strategy

Clinician-preferred ventilation strategy, including mode of ventilation and all ventilatory parameters

程序：Protocolised mechanical ventilation strategy

Invasive mechanical ventilation strategy delivered as outlined in relevant protocol documents for this domain.
其他：COVID-19 Immune Modulation (2) Domain

Patients admitted to participating hospitals with microbiological testing confirmed COVID-19 will be randomised to receive one of three interventions.

Note: this domain is now closed.
其他：No immune modulation for COVID-19

No immune modulating agent intended to be active against COVID-19 is to be administered.

Note: this intervention is now closed.

药品：Eritoran

Eritoran initiated with a 26.24 mg loading dose (6.56 mg/h IV for 4 hours), followed by a second 13.12 mg loading dose (6.56 mg/h IV for 2 hours) at 12 hours after initiation. Patients will then receive twenty-six 6.56 mg maintenance doses (3.28 mg/h IV for 2 hours) every 12 hours thereafter (total of 14 days). Dosing will be stopped if the patient is discharged from hospital

Note: this intervention is now closed.

药品：Apremilast

Apremilast administered 30mg twice daily for 14 days or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.
其他：ACE2 RAS Domain

Patients admitted to participating hospitals with suspected or microbiological testing confirmed COVID-19 will be randomised to one of up to five renin-angiotensin system blockade strategies.

Note: this domain is now closed.
其他：No renin-angiotensin system inhibitor

No RAS inhibitor (i.e. no ACEi or ARB) is to be administered up to the end of study day 10.

Note: this intervention is now closed.

药品：Angiotensin converting enzyme inhibitor

Site-preferred ACEi agent administered as directed by the treating clinician for 10 days or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.

其他名称：
  • 赖诺普利
  • 培哚普利
  • 雷米普利
  • 卡托普利
  • 依那普利
  • 群多普利
药品：Angiotensin Receptor Blockers

Site-preferred ARB agent administered as directed by the treating clinician for 10 days or until hospital discharge, whichever occurs first.

Note: this intervention is now closed.

其他名称：
  • 缬沙坦
  • 氯沙坦
  • 坎地沙坦
  • 厄贝沙坦
  • 奥美沙坦
  • 替米沙坦
药品：ARB + DMX-200

Site-preferred ARB agent administered in combination with DMX-200 for 10 days or until hospital discharge, whichever occurs first.

ARB administered as directed by the treating clinician. DMX-200 administered enterally at a dose of 120mg twice daily.

Note: this intervention is now closed.
其他：Cysteamine Domain

Patients admitted to participating hospitals with severe community-acquired pneumonia, including patients with suspected or proven influenza or COVID-19, will be randomised to receive no cysteamine, or cysteamine.

Note: this domain is now closed.
其他：No cysteamine

No cysteamine to be administered until the end of study day 10 or hospital discharge, whichever occurs first.

Note: this intervention is now closed.

药品：Cysteamine

Cysteamine administered every 8 hours at a dose of 5 mg/kg estimated or measured body weight (maximum dose of 500mg), for ten days or until ICU discharge, whichever occurs first.

Note: this intervention is now closed.
其他：Endothelial Domain

Patients admitted to participating hospitals with severe community-acquired pneumonia, including patients with suspected or proven influenza or COVID-19, will be randomised to receive no endothelial modulator or enteral imatinib.
其他：No endothelial modulator

No endothelial modulator (imatinib or another tyrosine kinase inhibitor targeting the same pathway as imatinib) is to be administered.

药品：Imatinib

Enteral imatinib will be administered as a single 800mg loading dose (study day 1) followed by 400mg daily until study day 14 or discharge.
其他：Influenza Immune Modulation

Patients with community-acquired pneumonia admitted to participating intensive care units with microbiological testing confirmed influenza infection will be randomised to one of three interventions.
药品：Tocilizumab

Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg.

Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period.

Note: this intervention is now closed.

药品：Tocilizumab

Tocilizumab will be administered as a single dose of 8mg/kg estimated or measured body weight, with a maximum total dose of 800mg. In children weighing less than 30kg, tocilizumab dose will be 12mg/kg.

Tocilizumab will be administered as an IV infusion via central or peripheral line over a one-hour period.

其他：No Immune Modulator for Influenza

No immune modulating agent intended to be active against influenza is to be administered.

药品：Baricitinib

Baricitinib will be administered at a dose that is determined by age and renal function, for up to 10 days or hospital discharge (whichever occurs first).
其他：COVID-19 Antiviral (II) Domain

Patients admitted to participating hospitals with microbiological testing confirmed COVID-19 will be randomised to one of up to four interventions.
其他：No antiviral agent for COVID-19

No antiviral agent intended to be active against SARS-CoV-2 infection is to be administered

药品：Nirmatrelvir/ritonavir

Nirmatrelvir-ritonavir will be administered at a dose that is dependent on renal function, for five days.

其他名称：
  • 紫杉醇
药品：Remdesivir

Remdesivir is administered at 200 mg on day one followed by 100 mg daily for a further four doses (i.e., for five doses in total) or until hospital discharge, whichever occurs first.

药品：Nirmatrelvir/ritonavir + remdesivir

Nirmatrelvir-ritonavir will be administered at a dose that is dependent on renal function, for five days. Remdesivir is administered at 200 mg on day one followed by 100 mg daily for a further four doses (i.e., for five doses in total) or until hospital discharge, whichever occurs first.
其他：Tropical Antibiotic Domain

Patients with community-acquired pneumonia in regions at locations where or when empiric cover for melioidosis is appropriate, and requiring empiric antibiotic therapy including cover for melioidosis, will be randomised one of two antibiotic interventions
药品：Amoxicillin-clavulanate + Ceftazidime + Macrolide

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

药品：Meropenem + Macrolide

The duration and dose of empiric antibiotics will be determined by the treating clinician and local guidelines or practice.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Survival and Recovery Trajectory up to day 90
大体时间：Day 90

The primary endpoint, named Survival and Recovery Trajectory, is a composite of: 90-day all-cause mortality and, among survivors, the number of days on which the patient was not receiving organ failure support during the index hospitalisation, up to the end of study day 28; and, among survivors who never receive organ failure support, hospital free days for the index hospitalisation up to the end of study day 28.

For the purposes of this endpoint, organ failure support is defined as:

  • Extracorporeal life support
  • Invasive mechanical ventilation
  • Non-invasive ventilation
  • High-flow nasal oxygen
  • Continuous infusion of vasopressors, inotropes or both
Day 90

次要结果测量

结果测量
措施说明
大体时间
All-cause mortality
大体时间：Day 90

All-cause mortality to day 90 post-randomisation
Day 90
Days alive and free from organ-failure support
大体时间：Day 28

Days alive and free from organ failure support during the index hospitalisation to day 28
Day 28
Days alive and out of hospital
大体时间：Day 28

Days alive and out of hospital for the index hospitalisation, to day 28
Day 28
Health-related Quality of life assessment
大体时间：6 months

EQ5D-5L and WHODAS 2.0 (not completed in all regions)
6 months

其他结果措施

结果测量
措施说明
大体时间
Domain-Specific Secondary Outcome
大体时间：During the index hospitalisation to Day 90 post-randomisation, unless otherwise specified

Each domain may specify domain-specific secondary outcomes. Please see relevant Domain-Specific Protocol Documents for details.
During the index hospitalisation to Day 90 post-randomisation, unless otherwise specified

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

UMC Utrecht

合作者

National University Hospital, Singapore
Berry Consultants
University of Pittsburgh Medical Center
Global Coalition for Adaptive Research
Australian and New Zealand Intensive Care Research Centre
Intensive Care National Audit & Research Centre
Nat Intensive Care Surveillance - MORU
Medical Research Institute of New Zealand
St. Marianna University School of Medicine
Unity Health
Universidad de La Sabana, Colombia

调查人员

  • 学习椅：Steve Webb, Prof、Monash University, Study Chair REMAP-CAP Australia
  • 学习椅：Colin McArthur, Dr、Medical Research Institute of New Zealand, Study Chair REMAP-CAP New Zealand
  • 学习椅：Marc Bonten, Prof、UMC Utrecht, Study Chair REMAP-CAP Europe
  • 学习椅：Lennie Derde, MD、UMC Utrecht, Coordinating Investigator REMAP-CAP Europe
  • 学习椅：John Marshall, Prof、Unity Health Toronto, Study Chair REMAP-CAP Canada
  • 学习椅：Derek Angus, Prof、University of Pittsburgh Medical Center, Study Chair REMAP-CAP USA
  • 学习椅：Luis Felipe Reyes, MD, MSc, PhD、Clínica Universidad de la Sabana, Study Chair REMAP-CAP Colombia

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

有用的网址

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2016年4月11日

初级完成 (估计的)

2028年6月1日

研究完成 (估计的)

2029年2月1日

研究注册日期

首次提交

2015年12月11日

首先提交符合 QC 标准的

2016年4月6日

首次发布 (估计的)

2016年4月13日

研究记录更新

最后更新发布 (实际的)

2026年11月4日

上次提交的符合 QC 标准的更新

2026年10月30日

最后验证

2026年10月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • U1111-1189-1653
  • 2015-002340-14 (EudraCT编号)
  • 602525 (其他赠款/资助编号：European Union, FP7-HEALTH-2013-INNOVATION-1, PREPARE)
  • 16/631 (其他赠款/资助编号：Health Research Council of New Zealand)
  • APP1101719 (其他赠款/资助编号：National Health and Medical Research Council, Australia)
  • 158584 (其他赠款/资助编号：Canadian Institute of Health Research)
  • 2023-507889-89-00 (克蒂斯)
  • 2023 (美国 NIH 拨款/合同)
  • 2015 (美国 NIH 拨款/合同)
  • 965313 (其他赠款/资助编号：European Union, Horizon 2020 research and innovation programme, ECRAID-Base)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

是的

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

在美国制造并从美国出口的产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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