Impact of Early Antibiotics on Non-Traumatic Out of Hospital Cardiac Arrest (OHCA)

Hamad Medical Corporation1,000 enrolled

Overview

Specific Aim : The specific aim is to conduct a randomized prospective clinical trial to determine whether no antibiotics in OHCA patients in the ED with very low likelihood of infection is non-inferior to early antibiotic treatment. Hypothesis a: 28-day all-cause mortality will be non-inferior in OHCA patients with very low likelihood of infection who do not receive antibiotic therapy compared with those who receive early antibiotic therapy Hypothesis b: There will be no difference in subsequent incidence of proven infections in the no antibiotics vs, early antibiotics groups Hypothesis c: There will be no difference in the length of ICU stay and overall hospital stay in the early antibiotics vs. no antibiotics groups

As above

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

1,000

Conditions

Infection, Bacterial Out-Of-Hospital Cardiac Arrest

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ● Adults aged \>18 years, presenting to HGH ED after out-of-hospital cardiac arrest * Patients with low likelihood of infection as per the definitions provided above * Ability to obtain informed consent from the subjects or their next of kin/family member/legal surrogate in case of incapacitation due to sedation, mechanical ventilation, etc. In case the next of kin is not available, an independent physician who is not a part of the investigative team will complete and sign the checklist as per HMC Policy "RES 11026\_Appendix 6.5". (see section 4.1.3 for details) A member of the investigative team and a witness will also sign this form before the potential subject is enrolled in the study. Exclusion Criteria: * Patients who have clear evidence of infection, as defined by criteria for the study. * Patients who have received antibiotics within the last 1 week prior to admission. * Patients with malignancy, except those who have been cured or in complete remission. * Females with known pregnancy. * Known immunocompromised states (including HIV/AIDS, transplant recipients on immunosuppressant drugs, long-term \[\> 3 weeks of prednisone \>5mg/day equivalent\] steroid therapy). * Patients on immunologic disease modifying agents (commonly known as "biologics") * Patients considered "brain-dead" or "vegetative state" * Patients transferred from another hospital, long term care facility or institution * Neutropenia (total WBC \<1,500/mm3 or absolute neutrophil count of \<1,000/mm3)

Outcomes

Primary Outcomes

28-day all-cause mortality. likelihood of infection whether they receive early antibiotic therapy or not.

Primary outcome measure is 28-day all-cause mortality in persons who receive no antibiotics compared with those who receive early antibiotics in OHCA patients.

Time frame: 28-day