Actively Recruiting

Phase 4
Age: 18Years +
All Genders
NCT05199324

Early Oral Switch for Uncomplicated Gram-negative Bacteraemia

Led by Tan Tock Seng Hospital · Updated on 2026-04-16

720

Participants Needed

1

Research Sites

212 weeks

Total Duration

On this page

Sponsors

T

Tan Tock Seng Hospital

Lead Sponsor

N

National University Hospital, Singapore

Collaborating Sponsor

AI-Summary

What this Trial Is About

Current management of uncomplicated Gram-negative bacteraemia entails prolong intravenous (IV) antibiotic therapy with limited evidence to guide oral conversion. This trial aim to evaluate the clinical efficacy and economic impact of early switch to oral antibiotics (within 72 hours from index blood culture collection) versus continuing standard of care IV therapy (for at least another 24 hours post-randomisation) for clinically stable / non-critically ill inpatients with uncomplicated Gram-negative bacteraemia.

CONDITIONS

Official Title

Early Oral Switch for Uncomplicated Gram-negative Bacteraemia

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • One or more blood cultures positive for Gram-negative bacteria showing infection
  • Able to be randomized within 72 hours of initial blood culture collection
  • Age 18 years or older (21 years or older in Singapore)
  • Latest Pitt bacteraemia score less than 4
  • Patient or legal representative can provide informed consent
Not Eligible

You will not qualify if you...

  • Uncontrolled infection focus needing surgery or unresolved abdominal sources
  • Central nervous system abscess or infections including meningitis
  • Undrained moderate-to-severe hydronephrosis
  • Complicated infections such as necrotising fasciitis, empyema, endocarditis, or endovascular infections
  • Septic shock despite fluid resuscitation or requiring inotropic/vasopressor support
  • Polymicrobial bacteraemia involving Gram-positive or anaerobic pathogens
  • Bacteraemia from vascular catheter or intravascular materials that cannot be removed
  • Specific Gram-negative pathogens resistant to study antibiotics (e.g., Burkholderia spp., Brucella spp.)
  • Resistance to both fluoroquinolones and trimethoprim-sulfamethoxazole
  • Allergic reactions to fluoroquinolones and sulfur drugs
  • Unable to take or absorb oral medications or unsuitable for IV therapy
  • Severely immunocompromised conditions including active leukemia, lymphoma, aplastic anemia, recent bone marrow transplant, congenital immunodeficiency, HIV/AIDS with low CD4 count, or neutropenia
  • Pregnant or breastfeeding women
  • Treatment not intended to cure infection (palliative care)
  • Unable to collect follow-up data for 30 days post-randomisation
  • Treating doctor considers trial enrollment not in patient's best interest
  • Previous enrollment in this trial

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 1 location

1

Tan Tock Seng Hospital

Singapore, Singapore, Singapore, 308433

Actively Recruiting

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Research Team

D

David Lye, MBBS

CONTACT

I

I. Russel Lee, PhD

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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Early Oral Switch for Uncomplicated Gram-negative Bacteraemia | DecenTrialz