NCT06699901: ACME

Antibiotic Concentrations After MassivE Transfusion Study

Recruiting now Last updated 11 February 2025

What this trial tests

trial testing Massive Transfusion Group in Adverse Effects in the Therapeutic Use of Other and Unspecified Agents Affecting Blood Constituents in 417 participants. Currently enrolling.

Timeline

30 September 2024

Primary endpoint
30 July 2027

30 September 2027

Quick facts

Lead sponsor	Brooke Army Medical Center
Status	Recruiting now
Study type	OBSERVATIONAL
Enrollment	417
Start date	30 September 2024
Primary completion	30 July 2027
Estimated completion	30 September 2027
Sites	2 locations across United States

Drugs / interventions tested

• Massive Transfusion Group
• Control Group — full drug profile →

Conditions studied

• Adverse Effects in the Therapeutic Use of Other and Unspecified Agents Affecting Blood Constituents — all drugs for Adverse Effects in the Therapeutic Use of Other and Unspecified Agents Affecting Blood Constituents →

Sponsor

Brooke Army Medical Center

Who can join

18 and older, any sex, with Adverse Effects in the Therapeutic Use of Other and Unspecified Agents Affecting Blood Constituents. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Combat and civilian trauma frequently result in open wounds that are at risk for infection. Data from the Department of Defense Trauma Registry demonstrate that 74% of combat trauma casualties have an open wound. The Committee on Tactical Combat Casualty Care, the Prolonged Field Care Working Group, and the Joint Trauma System clinical practice guidelines recommend antibiotic prophylaxis for open wounds after trauma. The civilian setting has similar risks of open wound infection after trauma. In parallel, current practice guidelines recommend the aggressive use of balanced blood products during resuscitation. It remains unclear how the replacement of blood after hemorrhage through transfusion may affect antibiotic concentrations. Data is necessary to better understand this relationship to enhance wound prophylaxis antibiotic dosing, particularly in severely wounded casualties who receive blood products during massive transfusions. It remains unclear how these resuscitation methods may alter pharmacokinetics. The investigators hypothesize that drug concentrations decrease in direct relation to the amount of blood transfused during low-volume, massive, and supermassive transfusion after trauma compared to patients who receive no blood products. The investigators seek to understand the relationship between drug concentrations and blood product administration using a non-compartmentalized model in the setting of hemorrhage. Specifically, they will (1) obtain drug concentrations at regular intervals during the first 12-18 hours after administration of antibiotics, (2) determine how much blood products and fluids are transfused during the 12 hours prior to antibiotic and 24 hours post-administration, and (3) perform data modeling to understand the relationship between blood transfusions and drug concentrations to inform data-driven dosing models. Liquid chromatography methods will be developed to measure drug concentrations. The investigators will conduct a prospective, multicenter study at two large trauma centers - Brooke Army Medical Center and the University of Colorado Hospital. They will seek to enroll any participant who is hospitalized or anticipated hospital admission for acute trauma and receives an antibiotic on the study list during their index hospitalization. They will then model the drug levels against the amount of blood and fluid infused to create an understanding of the pharmacokinetics of antibiotic wound prophylaxis.

Publications & conference data

No peer-reviewed publications indexed yet for this trial.