Clinical Research Directory

Targeted Antimicrobial Comparison for Treatment Individualization in Critically Ill Patients With CRAB Infection

The goal of this prospective, multicenter observational study is to learn which antibiotic treatment strategies are associated with better outcomes in critically ill adults with severe infections caused by carbapenem-resistant Acinetobacter baumannii (CRAB). The study will also evaluate the safety and costs of different treatments and develop prediction models to support personalized treatment decisions. The main questions it aims to answer are: Are there differences in 28-day survival between patients receiving polymyxin-based and non-polymyxin-based antibiotic treatments? Which treatment strategies are associated with better clinical recovery, bacterial clearance, and fewer adverse events, particularly acute kidney injury? Can clinical data and machine learning help predict treatment outcomes and support safer, more effective treatment decisions? Researchers will compare patients receiving polymyxin-based combination therapy with those receiving non-polymyxin-based treatments, including high-dose sulbactam-based, tigecycline-based, and newer antibiotic regimens. Treatment decisions will be made by the patients' treating physicians as part of routine clinical care, rather than assigned by the researchers. Participants will: Receive antibiotic treatments determined by their treating physicians. Have clinical information collected during hospitalization, including laboratory tests, bacterial cultures, organ function, antibiotic use, adverse events, and medical costs. Be followed for 28 days after starting targeted antibiotic treatment to assess survival and clinical outcomes. Be contacted by telephone if necessary to confirm their health status after hospital discharge.

Sulbactam-Durlobactam in CRAB Infection: A Real-World Cohort Study

This is a multicenter real-world observational cohort study designed to evaluate the effectiveness and safety of sulbactam-durlobactam in patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infections. Patients receiving sulbactam-durlobactam will be compared with those receiving other anti-CRAB regimens during the same period. The primary outcomes are 28-day all-cause mortality and clinical failure. Secondary outcomes include microbiological clearance, recurrence, length of hospital and ICU stay, duration of mechanical ventilation, and adverse events. To reduce confounding inherent in observational studies, propensity score methods, including matching and inverse probability weighting, will be applied. A nested therapeutic drug monitoring (TDM) sub-cohort will be established to explore the relationship between drug exposure and clinical outcomes.