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CompletedNCT01264549STRAWINSKIUpdated Jan 4, 2022

Stroke Adverse Outcome is Associated With Nosocomial Infections: PCTus- Guided Antibacterial Therapy in Severe Ischemic Stroke Patients (STRAWINSKI)

An interventional study of Procalcitonin assay - B.R.A.H.M.S PCT ultrasensitive Kryptor in Ischemic Stroke, sponsored by Charite University, Berlin, Germany. Completed at 6 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-01-04.

Sponsored by Charite University, Berlin, Germany · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
230
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

Development of stroke associated pneumonia (SAP) has a detrimental effect on stroke outcome. Biomarker-guided antibiotic treatment of patients at high risk for pneumonia may help to improve stroke outcome. Therefore, the investigators will evaluate whether intensified infection monitoring via Procalcitonin guiding an early standardized antibiotic treatment improves functional outcome after stroke compared with standard therapy based on current guidelines.

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Conditions studied

  • Ischemic Stroke

Keywords

  • ischemic stroke
  • stroke-associated infections
  • biomarkers
  • PCT
  • immune and infection parameters
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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 230 is above the median of 120 across 4,200 interventional studies indexed under Infections.

Browse Infections studies →

Lead sponsor

Charite University, Berlin, Germany is the lead sponsor of 836 studies on the registry; 129 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

  • age ≥18 years
  • stroke onset within the last 40 hours before randomisation
  • clinical diagnosis of a severe (NIHSS > 9), non-lacunar stroke in the middle cerebral artery territory
  • consent given by the patient or by his/her legitimate representative where patients are incapable of giving consent themselves

Exclusion criteria

Exclusion Criteria:

  • CT evidence of an intracerebral haemorrhage or a lacunar infarct as the probable cause of the current illness
  • Antibiotic use within the last 10 days
  • Suspected life expectancy of \< 3 months
  • Participation in other interventional trials (on pharmaceuticals or medical devices)
  • Pregnancy, lactation
  • Pre-stroke mRS score ≥ 4
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
230 participants (actual)

Study arms

  • Experimental
    PCT guided arm

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

  • No intervention
    Control

    Standard treatment

Interventions

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

    The physician will be given access to a PCT value for Day 1 - 7. Depending on the PCT concentrations, the protocol recommends or discourages from the use of antibiotics

    Also known as: Procalcitonin

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What researchers measure

Primary outcomes

  1. Modified Rankin scale (mRS 0-6) score 0-4 adjusted for baseline modified Rankin score

    To assess the proportion of patients with a modified Rankin scale (mRS 0-6) score 0-4 at day 90 adjusted for baseline modified Rankin score.

    Time frame: 3 months after onset of symptoms (stroke)

Secondary outcomes

  1. Proportion of patients receiving any antibiotic therapy

    To assess the proportion of patients receiving any antibiotic therapy for any duration within 90 days.

    Time frame: 3 months after onset of symptoms (stroke)

  2. Modified Rankin scale adjusted for baseline modified Rankin score

    To assess the Modified Rankin scale at day 90 adjusted for baseline modified Rankin score.

    Time frame: 3 months after onset of symptoms (stroke)

  3. Barthel Index adjusted for baseline Barthel Index

    To assess the Barthel Index (BI 0-100) at day 90 adjusted for baseline Barthel Index.

    Time frame: 3 months after onset of symptoms (stroke)

  4. Modified Rankin scale (mRS) score 0-4 adjusted for baseline modified Rankin score

    To assess the proportion of patients with a modified Rankin scale (mRS) score 0-4 at day 180 adjusted for baseline modified Rankin score.

    Time frame: 6 months after onset of symptoms (stroke)

  5. Modified Rankin scale adjusted for baseline modified Rankin score

    To assess the modified Rankin scale at day 180 adjusted for baseline modified Rankin score.

    Time frame: 6 months after onset of symptoms (stroke)

  6. Barthel Index adjusted for baseline Barthel Index

    To assess the Barthel Index at day 180 adjusted for baseline Barthel Index.

    Time frame: 6 months after onset of symptoms (stroke)

  7. Days alive and out of hospital

    To assess the days alive and out of hospital at day 90.

    Time frame: 3 months after onset of symptoms (stroke)

  8. Time to first event of death, re-hospitalization or recurrent stroke

    To assess the time to first event of death, re-hospitalization or recurrent stroke.

    Time frame: within 6 months after onset of symptoms (stroke)

  9. Proportion of events of post stroke infections

    To assess the proportion of events of post stroke infections to day 7.

    Time frame: within 7 days after onset of symptoms (stroke)

  10. Proportion of events of post stroke infection or death

    To assess the proportion of events of post stroke infection or death to day 7.

    Time frame: within 7 days after onset of symptoms (stroke)

  11. Medium number of days with fever (≥ 37,5°C) per patient

    To assess the medium number of days with fever (≥ 37,5°C) per patient to day 7.

    Time frame: within 7 days after onset of symptoms (stroke)

  12. Stroke volume analysis

    To investigate the effect of an early PCT-guided antiinfective therapy on stroke volume.

    Time frame: 6 months after onset of symptoms (stroke)

  13. Length of hospital stay

    To assess the length of hospital stay after acute stroke.

    Time frame: on discharge

  14. Hospital discharge disposition

    To assess the disposition on hospital discharge.

    Time frame: on discharge

  15. shift analysis of the mRS

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Study locations

6 sites
  • Charite University (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC)
    Berlin, Germany
  • Unfallkrankenhaus Berlin Neurologie
    Berlin, Germany
  • Vivantes Auguste Viktoria Klinikum Neurologie
    Berlin, Germany
  • Vivantes Neukölln Neurologie
    Berlin, Germany
  • Klinikum Frankfurt (Oder) Neurologie
    Frankfurt (Oder), Germany
  • Hospital Vall d'Hebron
    Barcelona, Spain
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References and documents

Publications

  • Ulm L, Hoffmann S, Nabavi D, Hermans M, Mackert BM, Hamilton F, Schmehl I, Jungehuelsing GJ, Montaner J, Bustamante A, Katan M, Hartmann A, Ebmeyer S, Dinter C, Wiemer JC, Hertel S, Meisel C, Anker SD, Meisel A. The Randomized Controlled STRAWINSKI Trial: Procalcitonin-Guided Antibiotic Therapy after Stroke. Front Neurol. 2017 Apr 24;8:153. doi: 10.3389/fneur.2017.00153. eCollection 2017. PubMed 28484421 ↗
  • Ulm L, Ohlraun S, Harms H, Hoffmann S, Klehmet J, Ebmeyer S, Hartmann O, Meisel C, Anker SD, Meisel A. STRoke Adverse outcome is associated WIth NoSocomial Infections (STRAWINSKI): procalcitonin ultrasensitive-guided antibacterial therapy in severe ischaemic stroke patients - rationale and protocol for a randomized controlled trial. Int J Stroke. 2013 Oct;8(7):598-603. doi: 10.1111/j.1747-4949.2012.00858.x. Epub 2012 Aug 28. PubMed 22925000 ↗
  • Hotter B, Hoffmann S, Ulm L, Montaner J, Bustamante A, Meisel C, Meisel A. Inflammatory and stress markers predicting pneumonia, outcome, and etiology in patients with stroke: Biomarkers for predicting pneumonia, functional outcome, and death after stroke. Neurol Neuroimmunol Neuroinflamm. 2020 Feb 25;7(3):e692. doi: 10.1212/NXI.0000000000000692. Print 2020 May. PubMed 32098866 ↗
  • Hotter B, Hoffmann S, Ulm L, Meisel C, Bustamante A, Montaner J, Katan M, Smith CJ, Meisel A. External Validation of Five Scores to Predict Stroke-Associated Pneumonia and the Role of Selected Blood Biomarkers. Stroke. 2021 Jan;52(1):325-330. doi: 10.1161/STROKEAHA.120.031884. Epub 2020 Dec 7. PubMed 33280547 ↗
  • Hotter B, Ulm L, Hoffmann S, Katan M, Montaner J, Bustamante A, Meisel A. Selection bias in clinical stroke trials depending on ability to consent. BMC Neurol. 2017 Dec 4;17(1):206. doi: 10.1186/s12883-017-0989-9. PubMed 29202730 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 4, 2022, 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
NCT01264549
Lead sponsor
Charite University, Berlin, Germany
Collaborators
Brahms AG, NeuroCure Clinical Research Center, Charite, Berlin
Responsible party
Andreas Meisel (Prof. Dr. Andreas Meisel, Charité University, Berlin, Germany (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC), Charite University, Berlin, Germany) — Principal investigator
First posted
Dec 22, 2010
Start date
Dec 2010
Primary completion
Oct 2014
Completion
Oct 2014
Last update
Jan 4, 2022

Study contacts

Andreas Meisel, MD
principal investigator · Charité University Berlin (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC)
Stefan Anker, MD PhD
principal investigator · Charité University Berlin (Dept of Cardiology)

Oversight

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

Not currently enrolling

This study is completed, as verified in Dec 2021. You cannot join it, but the record below documents what was studied.

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