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TerminatedNCT00407147Updated Jan 18, 2012

Procalcitonin Level to Discontinue Antibiotics on ICU Patients With no Obvious Site of Infection

A Phase 4 interventional study of Procalcitonin assay - B.R.A.H.M.S PCT sensitive Kryptor in Infection, Bacterial Infection and Sepsis, sponsored by Brahms AG. Terminated at 3 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2012-01-18.

Sponsored by Brahms AG · Phase 4, Interventional, and Treatment

Why this study was terminated
termination due to futility (very slow patient enrollment)
Phase
Phase 4
Study type
Interventional
Enrollment
11
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

The purpose of this study is to test whether a U.S. Food and Drug Administration (FDA) approved laboratory test (PCT Kryptor) can help doctors make better decisions on the need for antibiotic therapy in ICU patients with suspected infections.

Read the detailed description

The study is undertaken as prospective, randomized, controlled, multicenter trial. The study population, ICU patients with empiric antibiotic treatment due to suspected but unproven infection, is randomly assigned to either a Standard Care Group or a Procalcitonin (PCT) Guided Group. In the standard care group, antibiotic treatment would be based totally on clinical decision making with "traditional thought processes" (i.e., cultures, response to antibiotics, risk of untreated infection, other laboratory findings, etc.). The PCT guided group will use the same "traditional thought processes" and in addition the physician will be given access to a PCT value for Day 1 and Day 4 along with the recommended thresholds for likelihood of infection. In conjunction with other laboratory findings and clinical assessments the threshold of PCT is used to continue or discontinue empiric antibiotic treatment.

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Conditions studied

  • Infection
  • Bacterial Infection
  • Sepsis

Keywords

  • bacterial infection
  • empiric antibiotic treatment
  • duration antibiotic treatment
  • reduce antibiotic treatment
  • procalcitonin
  • PCT Kryptor
  • sepsis
  • Intensive Care Unit
  • antibiotic treatment
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In context

Infections

6,687 studies on the registry are indexed under Infections; 807 are open to participants now.

This study's enrollment of 11 is below the median of 120 across 4,200 interventional studies indexed under Infections.

Browse Infections studies →

Lead sponsor

Brahms AG is the lead sponsor of 8 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Suspected infection (no clear-cut source of infection) as defined by the treating physician
  • Empiric antibiotic treatment
  • No clear-cut source of infection by clinical or microbiological criteria
  • ICU patient
  • Informed consent

Exclusion criteria

Exclusion Criteria:

  • Age \<18 years
  • Pregnancy
  • Hemodynamic instability defined as persistent hypotension, need for on-going aggressive resuscitation and/or vasopressor support to maintain an adequate mean arterial blood pressure
  • Need for antibiotic prophylaxis
  • Patient withdrawn from empiric antibiotic treatment before Day 4
  • Severely immuno-compromised patient (liver cirrhosis (Child-Pugh class C), immunosuppressive drugs after transplantation, neutropenia (absolute neutrophil count \<1000 counts/L), CD-4 count less than 200)
  • Patient with suspected bacterial or fungal endocarditis
  • Patient with suspected meningitis
  • Cardiopulmonary bypass within the last 7 days1)
  • Major surgery within the last 7 days (surgery that induces a major inflammatory response such as heart or aortic surgery or major abdominal surgery (i.e. duodenopancreatectomy) or any surgery requiring massive blood transfusion.)
  • Multiple trauma within the last 7 days
  • Cardiopulmonary resuscitation (CPR) within the last 7 days
  • Burns >20% body surface area
  • Patient in terminal status referred for palliative care
  • Patient with advanced directives or Do Not Resuscitate (DNR) orders
  • Patient who is already enrolled in another therapeutic clinical study
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
11 participants (actual)

Study arms

  • No intervention
    Control

    Standard treatment

  • Experimental
    PCT

    PCT guided arm

    Device: Procalcitonin assay - B.R.A.H.M.S PCT sensitive Kryptor

Interventions

  • DeviceProcalcitonin assay - B.R.A.H.M.S PCT sensitive Kryptor

    antibiotic treatment based on clinical decision making with "traditional thought processes" used in both groups. In addition the physician will be given access to Procalcitonin values with recommended thresholds for likelihood of infection.

    Also known as: B.R.A.H.M.S, Kryptor, Procalcitonin

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What researchers measure

Primary outcomes

  1. Days on antibiotics beginning with day 4 until the first day without antibiotics (up to max. 28 days follow up)

    Time frame: 28 days

Secondary outcomes

  1. Days on antibiotics during ICU stay

    Time frame: up to 28 days

  2. Sepsis classification

    Time frame: up to 28 days

  3. SOFA score (modified)

    Time frame: up to 28 days

  4. ICU or hospital mortality up to 28 days

    Time frame: up to 28 days

  5. Frequency of infections

    Time frame: up to 28 days

  6. ICU and hospital length of stay

    Time frame: up to 28 days

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Study locations

3 sites
  • Saint Louis University - medical intensive care unit
    Saint Louis, Missouri 63110, United States
  • Cooper University Hospital
    Camden, New Jersey 08103, United States
  • Rhode Island Hospital
    Providence, Rhode Island 02903, United States
08

References and documents

Publications

  • Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH, Wolff M, Spencer RC, Hemmer M. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA. 1995 Aug 23-30;274(8):639-44. PubMed 7637145 ↗
  • Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez-Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C. Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med. 2003 Dec;31(12):2742-51. doi: 10.1097/01.CCM.0000098031.24329.10. PubMed 14668610 ↗
  • Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, Muller B. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004 Feb 21;363(9409):600-7. doi: 10.1016/S0140-6736(04)15591-8. PubMed 14987884 ↗
  • Rau B, Steinbach G, Gansauge F, Mayer JM, Grunert A, Beger HG. The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis. Gut. 1997 Dec;41(6):832-40. doi: 10.1136/gut.41.6.832. PubMed 9462219 ↗
  • Meisner M, Tschaikowsky K, Palmaers T, Schmidt J. Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care. 1999;3(1):45-50. doi: 10.1186/cc306. PubMed 11056723 ↗
  • Bergmans DC, Bonten MJ, Gaillard CA, van Tiel FH, van der Geest S, de Leeuw PW, Stobberingh EE. Indications for antibiotic use in ICU patients: a one-year prospective surveillance. J Antimicrob Chemother. 1997 Apr;39(4):527-35. doi: 10.1093/jac/39.4.527. PubMed 9145828 ↗
  • Roder BL, Nielsen SL, Magnussen P, Engquist A, Frimodt-Moller N. Antibiotic usage in an intensive care unit in a Danish university hospital. J Antimicrob Chemother. 1993 Oct;32(4):633-42. doi: 10.1093/jac/32.4.633. PubMed 8288506 ↗
  • Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985 Oct;13(10):818-29. PubMed 3928249 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 18, 2012, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00407147
Lead sponsor
Brahms AG
Responsible party
Sponsor
First posted
Dec 4, 2006
Start date
Jul 2008
Primary completion
Jun 2009
Completion
Jun 2009
Last update
Jan 18, 2012

Study contacts

Phil Dellinger, M.D.
study chair · The Cooper Health System

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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