PhD Scientific Days 2026

Poster Session 1.I - Theoretical and Translational Medicine

Appropriateness of empirical antibiotic therapy and outcomes of critically ill patients with new-onset infection - preliminary analysis of the multicentre, KIPRUN trial

Name of the presenter

Papp, Márton

Institute/workplace of the presenter

Semmelweis University, Department of Intensive Therapy

Authors

Márton Papp¹, Nikolett Kiss¹, Caner Turan¹, László Zubek¹, Dilán Márk Karim¹, Péter Hegyi², Zsolt Molnár¹
1: Semmelweis University, Department of Intensive Therapy
2: Semmelweis University, Centre for Translational Medicine

Text of the abstract

Introduction
Appropriate antibiotic (AB) therapy remains a challenge in critically ill patients. Inappropriate AB therapy is associated with worse outcomes; however, data for intensive care unit (ICU)-acquired infections are lacking.
Aims
Our aim was to compare the effects of appropriate and inappropriate empiric AB therapy in critically ill patients with new-onset ICU-acquired infection.
Methods
This is a preliminary analysis of the KIPRUN (KInetics of Procalcitonin to Reduce Unnecessary aNtibiotic use) multicentre randomized controlled trial (clinicaltrials.gov identifier: NCT07211620) initiated at Semmelweis University (Department of Intensive Therapy). We compared the effects of appropriate versus inappropriate AB therapy on ICU length of stay, number of secondary infections, number of Clostridioides difficile infections (CDI), ICU-, and 28-day mortality. Statistical analysis was done using IBM SPSS Statistics (version 30.0).
Results
From November 1, 2025, to April 15, 2026, we enrolled 24 patients in the trial. Time until randomization from unit admission was 13,1±11 days; patients were 61,2±18,5 years old (mean±SD), 7 of them were women (7/24, 29,2%). 87.5% (21/24) of the participants were mechanically ventilated upon inclusion. The suspected source of infection was the lower respiratory tract in 17 patients (17/24, 70.8%). AB therapy was initiated in 20 patients (20/24, 83%), of which 60% was appropriate (12/20), and 40% was inappropriate (8/20). There was no difference between groups with appropriate and inappropriate AB therapy in ICU mortality (25% vs 25%, p=1), 28-day mortality (36% vs 28%, p=1), ICU length of stay (27 (40) days vs 24 (37) days (median(IQR), p=0.792) and the number of secondary infections (3/12 vs 1 /8, p=0.619). No CDI was recorded.
Conclusion
Appropriateness of AB therapy in critically ill patients treated with ICU-acquired infections may not have an effect on ICU length of stay, mortality and the number of secondary infections; however, we cannot draw firm conclusions due to the low number of patients.
Funding
Our project is supported by the 2025-2.1.1-EKÖP-2025-00014 University Research Scholarship Program of the Ministry for Culture and Innovation, funded by the National Research, Development, and Innovation Fund. Additional support was provided by the Hungarian National Research, Development and Innovation Office [K 138816]