Centre for Trials Research contributes to study on antibiotic use in children
18 January
The Centre for Trials Research (CTR), funded by Health and Care Research Wales, has taken part in the largest trial of its kind in the UK to determine if a blood test called procalcitonin (PCT) could help reduce the duration of antibiotic treatment in hospitalised children.
The findings, published in the Lancet Child & Adolescent Health, are part of the ‘Biomarker-guided duration of Antibiotic Treatment in Children Hospitalised with confirmed or suspected bacterial infection’ (BATCH) trial. BATCH is a national research trial seeking to tackle antibiotic overuse in hospitalised children and reduce the spread of antimicrobial resistance (AMR).
Despite promising previous analysis, the study, led by the University of Liverpool, found that using the PCT biomarker to guide treatment decisions did not reduce antibiotic duration when compared to usual care.
Dr Emma Thomas-Jones, Principal Research Fellow and Deputy Director of Infection, Inflammation and Immunity Trials at CTR, said: “Research is vital to improving the management of serious bacterial infections, like sepsis.
“On behalf of the team at CTR, it has been a pleasure working with Professor Carrol on this important trial. This is a testament to the multi-disciplinary team involved in delivering these results, which will make a real difference by providing clear evidence on the use of procalcitonin as a biomarker in guiding clinical decision making about antibiotic discontinuation in children with serious bacterial infections.”
Chief investigator the University of Liverpool’s Professor Enitan Carrol added: “Whilst the study did not demonstrate benefit from the additional procalcitonin test, there is important learning for future biomarker-guided trials in the NHS.
“The BATCH study was a pragmatic trial evaluating if the intervention works under real-world conditions where clinicians do not have to adhere to diagnostic algorithms about antibiotic discontinuation. Adherence to the algorithm was low in our study, and there were challenges in integrating the test into routine clinical workflows. The study highlights the importance of including behaviour change and implementation frameworks into pragmatic trial designs.”
Antibiotic overuse is a key driver of AMR, one of the world’s greatest public health challenges. Infections caused by resistant bacteria lead to longer hospital stays, higher healthcare costs and increased mortality. Children are especially vulnerable, and smarter use of antibiotics is essential to protect their future health.
This study, funded by the National Institute for Health and Care Research (NIHR), conducted across 15 hospitals, enrolled nearly 2,000 children aged between 72 hours and 18 years with suspected bacterial infections.
The researchers found that adding the PCT test to routine care did not reduce the duration of intravenous (IV) antibiotic use. The test was safe but costlier than standard methods, and healthcare teams faced challenges integrating it into their decision-making processes.