PRONTO Trial at the University Hospital of Wales Emergency Unit enrols 300 patients
20 September 2022
More than 300 patients with suspected sepsis have been successfully enrolled in the PRONTO Trial at the University Hospital of Wales.
The PRONTO trial (Procalcitonin and NEWS2 evaluation for Timely identification of sepsis and Optimal use of antibiotics in the emergency department) is funded by the NIHR and led by the University of Liverpool.
The Emergency Unit at the University Hospital of Wales opened to recruitment into the PRONTO Trial in July 2021 and the trial aims to improve treatment in patients with suspected sepsis and optimise the use of broad-spectrum antibiotics.
Sepsis is a life-threatening reaction to an infection and the optimal treatment for patients with suspected sepsis includes early recognition, prompt antibiotics and intravenous (IV) fluids. However, the current method used by clinicians is designed to identify the sickest patients and can over-diagnose sepsis. This means many patients with suspected sepsis don’t have an underlying bacterial infection and therefore won’t benefit from antibiotics.
The overuse of unnecessary antibiotics can cause antibiotic resistance and according to the World Health Organization (WHO), antibiotic resistance is an increasingly serious threat to global public health.
Using the National Early Warning Score (NEWS2) to initially identify the patients most at risk, the PRONTO Trial team are researching whether the point of care testing (PoCT) of procalcitonin (a blood test that helps to identify a bacterial infection) at the bedside improves patient outcomes and antibiotic use.
The PoCT provides a result within 20 minutes and poses minimal disruption, enabling clinicians to better risk stratify patients with suspected sepsis and help guide decision-making and avoid unnecessary use of antibiotics.
So far, 308 patients from UHW have been recruited to take part in the trial.
Dr Jonathan Underwood, Principal Investigator and Infectious Diseases Consultant at The University Hospital of Wales, said: “Our two research nurses, Non Smith and Lauren Thomas, are embedded within our Emergency Unit which means they are able to identify patients who may benefit from being part of the trial really quickly. They have been absolutely amazing and their passion, dedication and hard work are one of the main reasons the trial has been such a big success”.
“The trial is currently awaiting approval to be extended to April 2023 and ultimately, we hope to show that the additional bedside testing can improve patient care and reduce the use of unnecessary antibiotics.”
Delivered as a partnership between Cardiff University’s Centre for Trials Research (CTR) and the University of Liverpool, the PRONTO Trial has the potential to show that PoCT is superior to current practice which could lead to improved care and reduce the overuse of antibiotics.
Professor Neil French, Co-Chief Investigator at the University of Liverpool, said: “The PRONTO trial is attempting to provide the clearest possible answer as to how a rapidly available biomarker test can be used to improve the outcome of sepsis and set a standard for future developments in sepsis diagnosis and care”.