Hospital patients who develop infections where 10 per cent die to be offered double antibiotics in trial

Patients with serious abdominal infections are usually given a two-week course, but often this is unsuccessful.

Now, researchers at the University of Leeds and the University of York are trialling a month-long course to establish whether it is more effective at clearing up the infection.

The EXTEND trial is funded by the National Institute for Health and Care Research (NIHR) and is co-led by Dr Andrew Kirby, Associate Professor at the University of Leeds’ School of Medicine and an NHS Consultant in Microbiology, and Mr Dermot Burke, Associate Professor in Surgery in Leeds’ School of Medicine.

The EXTEND trial is due to start in August 2022 and will run for three years.

It will follow patients for six months.

Half will receive a course of antibiotics prescribed by their doctor, normally for a week or two, and the other half will receive the 28-day course.

The trial will be open to patients in hospital with a serious abdominal infection.

Dr Kirby said: “There can be aversion to prescribing longer courses of antibiotics due to the risk of antimicrobial resistance to the drugs. But these infections are extremely serious and the current treatments do not work for a large proportion of patients.”

Serious abdominal infections happen when the intestine is damaged, usually by bowel surgery or a disease, causing bacteria living in the intestine to leak into the surrounding cavity.

These infections are a leading cause sepsis in patients on intensive care units.

Sepsis in the UK kills more people than breast, bowel and prostate cancer combined.

The problem with short antibiotic courses is that 20 per cent of patients are not cured and 10 per cent die following their infection.

Currently, doctors rely on blood tests and patient-reported symptoms.

However, if the bacteria have not been fully eradicated by the antibiotics, they can start to regrow, resulting in a recurrence of the infection and potentially more episodes of sepsis.

This is why researchers now want to establish whether a set 28-day course of antibiotics can cure these infections more effectively than a doctor deciding when to stop the course.