At UMC Utrecht, much scientific research is being conducted with the objective to prevent or reduce antibiotic resistance. In one of these studies, researchers are investigating which antibiotic treatment provides the best outcome in adults hospitalized with sepsis. This will allow this patient group in the future to receive the optimal antibiotic treatment based on sound scientific evidence. These results also contribute to a careful antibiotic policy that inhibits the development of antibiotic resistance.

Sepsis is a life-threatening syndrome caused by a dysregulated inflammatory response of the body to pathogens, requiring hospitalization and treatment with antibiotics. Doctors in the Netherlands currently treat patients who are admitted to the emergency room with sepsis differently. Depending on the hospital, either a combination treatment of two different antibiotics is started immediately or only one antibiotic is given. However, there is no convincing evidence that such combination treatment also leads to a better outcome for the patient. Studies conducted so far show no difference between the treatments. This is because they either had too small a number of participants or did not have the right study design.

One antibiotic or a combination of antibiotics

This new study - coordinated by UMC Utrecht - is investigating whether a standard treatment with the antibiotic ceftriaxone (a cephalosporin antibiotic) works as well as a combination of cefuroxime plus a short-term aminoglycoside antibiotic (such as gentamicin or tobramycin) in patients admitted to the hospital with sepsis. The researchers are looking primarily at efficacy, safety and cost-effectiveness of these treatment options.

Physician-researcher and coordinator of the study Eva Koekenbier, MD (research program Epidemiology of Infectious Diseases, UMC Utrecht) explains: "In the context of prevention of antibiotic resistance, it is very important that when a bacterial infection occurs, we can treat the patient as quickly as possible and with the most appropriate antibiotic (or combination of antibiotics). This new study contributes to the rational use of antibiotics."

Physician-researcher Eva koekenbier

Nationwide study

The goal of this nationwide study in more than 3,000 patients admitted to the hospital with sepsis through the emergency room is to determine whether a combination therapy of two antibiotics provides a better outcome than monotherapy. This is being done by looking at survival, length of hospitalization, days of antibiotic treatment and readmission rates, amongst others. Furthermore, the researchers are looking at cost-effectiveness and long-term quality of life. In the study - which is financially supported by ZonMw - 9 Dutch hospitals (both UMCs and general hospitals) are collaborating to achieve results as soon as possible. The investigators expect to have these available in about 3 years."

Prevention of antibiotic resistance

The results of this study will influence national guidelines for the treatment of patients with sepsis. Eva Koekenbier, MD says: "With the help of the outcome of this study, we hope to adjust the national guidelines for antibiotic use. This will allow each sepsis patient to receive the right antibiotic treatment in the future based on sound scientific research. By properly investigating what is the best choice for these patients, the results of our study contribute to a careful antibiotic policy, which will help to inhibit the development of antibiotic resistance."