NIHR | Manchester Biomedical Research Centre

Manchester BRC researcher examines antibiotic treatment for sepsis in COVID-19

Professor Paul Dark, Manchester BRC Respiratory Non-fungal Infections Programme Lead and researchers from a leading NIHR study are investigating how to improve the use of antibiotics for patients with COVID-19 at risk of sepsis.

COVID-19 is caused by a coronavirus infection and, like any other infection, it puts you in danger of developing sepsis, a life-threatening reaction to an infection. This happens when the body’s immune system overreacts to an infection, which can lead to organ failure and death.

Most patients with COVID-19 who have to be admitted to hospital develop lung infection (pneumonia). Progression to sepsis often occurs in critically ill patients and is a common cause of COVID-19 related deaths. People who have survived the virus are also likely to have an increased risk of developing sepsis during their recovery.

The ADAPT-Sepsis study, led by researchers at Salford Royal NHS Foundation Trust, started in 2017, and aims to make antibiotic prescribing for critically ill patients with suspected sepsis more effective and targeted. Experts are examining whether one of two different markers in the blood is more effective to guide doctors on the safe use of antibiotics.

Now the team are including seriously ill COVID-19 patients in their work. This is particularly important for severe infections caused by coronavirus because there is no evidence that antibiotics are effective at treating viral infections.

The study is one of a number of COVID-19 studies that have been given urgent public health research status by the Chief Medical Officer and Deputy Chief Medical Officer for England.

Chief Investigator Professor Paul Dark, who is also Consultant in Critical Care Medicine at Salford Royal and Professor of Critical Care Medicine at The University of Manchester, said  the study is hugely important because of the dangers of antibiotic overuse that could lead to unwanted patient effects (such as drug-related organ damage, allergic reactions or development of other infections), diminished supplies of antibiotics and increases in downstream antibiotic resistance – an acknowledged global health challenge.

Professor Dark said: “During the first wave of the pandemic, there was widespread use of antibiotics in hospitalised patients with severe pneumonia and sepsis as a result of COVID-19.

Professor Paul Dark

“Research suggests that overuse of antibiotics is associated with further risk of hospital-acquired infection and sepsis as patients recover which can be even more difficult to treat.

“This is why it is so important that hospital staff have the best possible guidance on antibiotic treatment decisions in adult patients with severe pneumonia and sepsis.”

As we go into winter and the second wave of the pandemic, we expect to see more patients with viral and bacterial respiratory infections and this study has a vital role in how we look after them and future patients.

The study, funded by the NIHR’s Health Technology Assessment (HTA) Programme and supported by the Clinical Research Network (CRN), also involves researchers from The University of Manchester and Warwick Clinical Trials Unit at the University of Warwick.

More information on ADAPT-Sepsis is available on the NIHR website.

NIHR has established a single, national prioritisation process that has been established to prevent duplication of effort and to ensure that the resources and capacity of the health and care system to support COVID-19 research are not exceeded. Learn more about this process and other studies given urgent public health status on the NIHR website.