CompletedNot Applicable

Pulmonary Diffusion of Antibiotics in Patients Admitted for ARDS Following SARS-CoV-2 Pneumonia

France34 participantsStarted 2022-11-24

Plain-language summary

Patients on mechanical ventilation (MV) following SARS-CoV-2 pneumonia frequently develop ventilator-associated pneumonia (VAP). The incidence of MVAP during SARS-CoV-2 infections ranges from 50 to nearly 90%. In addition, up to 80% of recurrences of VAP (a new episode, most often attributable to the same bacteria) have been described, reflecting the failure of the initial antibiotic therapy. This incidence is much higher than that described for other etiologies of acute respiratory distress syndrome (ARDS). The investigators hypothesize that during VAP, there is an alteration of the diffusion of intravenous antibiotics in the lung parenchyma in COVID-19 patients in relation to several factors characteristic of SARS-CoV-2 infection. This altered diffusion may explain the high number of recurrences of MVAP compared to non-COVID-19 patients.

Who can participate

Age range18 Years

SexALL

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Exclusion criteria

✕. Patients for whom PIP-TAZ is administered as a discontinuous infusion.
✕. Contraindication to the realization of a mini-LBA: patient whose respiratory state is too precarious for the realization of a mini-LBA for intra pulmonary antibiotics dosage (SpO2\<94% under FiO2 100% under VM), presence of a non drained pneumothorax, bronchial prosthesis, recent bronchial suture
✕. Patient with a second episode of PAVM.
✕. Patients with KDIGO stage ≥ 3 renal failure or extra-renal replacement therapy (creatinine measurement on the day of inclusion, performed as part of routine care).
✕. Patient on ExtraCorporeal Membrane Oxygenation (ECMO) or ExtraCorporeal CO2 Removal (ECCO2R).
✕. Pregnant or breastfeeding women, patients under guardianship or trusteeship, deprived of liberty
✕. Patients who are moribund or for whom limitations of active therapies have been decided.
✕. Any condition, which in the opinion of the investigator, would not allow the implementation of the study procedures.

What they're measuring

Compare the pulmonary diffusion of piperacillin

Timeframe: 48 hours following antibiotics administration

Trial details

NCT IDNCT05464680

SponsorAssistance Publique Hopitaux De Marseille

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2025-05-09

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