Using drug monitoring to improve treatment for tough bacterial infections

Evaluation of the Efficacy and Safety of Antibiotic Therapeutic Drug Monitoring (TDM) in Patients With Difficult-to-Treat Gram-Negative Bacterial (DT-GNB) Infections

Not applicable Interventional Singapore General Hospital · NCT05942157

This study is testing if using drug monitoring can help doctors choose the right antibiotics to save lives in patients with serious Gram-negative bacterial infections and sepsis.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment810 (estimated)
Ages16 Years to 99 Years
SexAll
SponsorSingapore General Hospital Academic / other
Locations1 site (Singapore)
Trial IDNCT05942157 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the effectiveness of therapeutic drug monitoring (TDM) in guiding antibiotic therapy for patients suffering from difficult-to-treat Gram-negative bacterial infections, particularly those experiencing sepsis and hemodynamic instability. The study is designed as a prospective, open-label, randomized controlled trial comparing TDM-guided therapy to standard antibiotic treatment. By monitoring drug levels for 11 antibiotics, the trial aims to determine if TDM can significantly reduce 14-day all-cause mortality rates in septic patients. The findings could lead to a shift in treatment practices for managing severe bacterial infections.

Who should consider this trial

Good fit: Ideal candidates for this study are patients aged 16 years or older who are receiving intravenous antibiotic therapy for at least three days.

Not a fit: Patients who are pregnant, receiving antibiotics only as prophylaxis, or on palliative care with a life expectancy of less than 48 hours may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly reduce mortality rates in patients with severe bacterial infections and improve overall treatment outcomes.

How similar studies have performed: While the concept of TDM is established, this specific application in difficult-to-treat Gram-negative infections is relatively novel and has not been extensively tested in prior studies.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* 16 years or older
* Receive intravenous therapy of the study antibiotics
* Antibiotic treatment should be aimed for at least 3 days at time of inclusion

Exclusion Criteria:

* Pregnancy
* Antibiotics cessation before first blood sample collection
* Receiving antibiotics only as prophylaxis
* On palliative care or with less than 48 hours of life expectancy

Where this trial is running

Singapore

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions SepsisHemodynamic InstabilityBacterial InfectionsTherapeutic Drug MonitoringAntimicrobial ResistanceGram-negative BacteriaBeta-LactamsFosfomycin
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.