Professor Paul Dark

Research to examine antibiotic treatment for sepsis in Covid-19

An internationally important research study is looking to improve the use of antibiotics for patients with Covid-19 at risk of sepsis.

Covid-19 is caused by a coronavirus infection and, like any other infection, it puts you in danger of developing sepsis, a life-threatening reaction to an infection. It happens when the body’s immune system overreacts to an infection, which can lead to organ failure and death. Most patients with Covid-19 who have to be admitted to hospital develop lung infection (pneumonia). Progression to sepsis often occurs in critically ill patients and is a common cause of Covid-19 related deaths.  People who have survived Covid-19 are also likely to have an increased risk of developing sepsis during their recovery*.

Now the expert team behind the ADAPT-Sepsis study – including doctors and scientists from Salford Royal NHS Foundation Trust, The University of Manchester and Warwick Clinical Trials Unit at the University of Warwick – are to include seriously ill Covid-19 patients in their work to make antibiotic prescribing for critically ill patients with suspected sepsis more effective and targeted. The world-first study, which started in 2017 and is funded by the National Institute for Health Research, is examining whether one of two different markers in the blood is more effective to guide doctors on the safe use of antibiotics. This is particularly important for severe infections caused by coronavirus because there is no evidence that antibiotics are effective at treating viral infections.

Chief Investigator Professor Paul Dark, Consultant in Critical Care Medicine at Salford Royal and Professor of Critical Care Medicine at The University of Manchester and the NIHR Manchester Biomedical Research Centre, says this is hugely important because of the dangers of antibiotic overuse that could lead to unwanted patient effects (such as drug-related organ damage, allergic reactions or development of other infections), diminished supplies of antibiotics and increases in downstream antibiotic resistance – an acknowledged global health challenge.

He said: “During the first wave of the pandemic, there was widespread use of antibiotics in hospitalised patients with severe pneumonia and sepsis as a result of Covid-19. Research suggests that overuse of antibiotics is associated with further risk of hospital-acquired infection and sepsis as patients recover which can be even more difficult to treat.

“This is why it is so important that hospital staff have the best possible guidance on antibiotic treatment decisions in adult patients with severe pneumonia and sepsis.

“As we go into winter and the second wave of the pandemic, we expect to see more patients with viral and bacterial respiratory infections and this study has a vital role in how we look after them and future patients.”

The ADAPT-Sepsis study is one of a number of COVID-19 studies that have been given urgent public health research status by the Chief Medical Officer/ Deputy Chief Medical Officer for England. This means that it is being prioritised to gather the necessary clinical evidence that will inform national policy and enable new diagnostic tests, treatments and vaccines to be developed and tested for Covid-19. It is taking place in more than 30 hospitals across the UK.

* One in five Covid-19 survivors who required hospital treatment is at risk of sepsis within a year of being discharged, according to the UK Sepsis Trust (UKST)

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