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Anti-bacterial agent

Early Paramedic Treatment for Sepsis (PITSTOP Trial)

Phase 4
Recruiting
Led By Damon Scales, MD PhD FRCPC
Research Sponsored by Dr. Damon Scales
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Age ≥ 18 years
Patients with Sepsis, defined as (all 3 must be present): i) Paramedic suspects possible infection: e.g. suspected pneumonia, urinary tract infection, skin infection, bone and joint infection, intra-abdominal infection, meningitis ii) Presence of fever: Temperature ≥ 38.0°C measured by paramedic or history of fever during previous 24 hours iii) Presence of hypotension: Systolic blood pressure < 100mmHg
Must not have
Receiving oral or subcutaneous anticoagulants or low molecular weight heparin
Suspected acute congestive heart failure (CHF)
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 90 days
Awards & highlights
Pivotal Trial
All Individual Drugs Already Approved
Approved for 10 Other Conditions
Drug Has Already Been Approved

Summary

This trial will help to determine whether paramedics can improve survival for patients with sepsis by providing early treatment.

Who is the study for?
Adults over 18 with suspected sepsis, indicated by possible infection, fever (≥38.0°C), and low blood pressure (systolic <100mmHg) can join. Excluded are those with stroke, heart failure, penicillin/cephalosporin allergy, severe trauma or bleeding, recent cardiac arrest or myocardial infarction, fluid overload signs, C. difficile infection in the past 6 weeks, pregnancy/breastfeeding or on certain anticoagulants.
What is being tested?
The PITSTOP trial is testing if early treatment for sepsis by paramedics improves survival rates. It compares two approaches: one group receives an antibiotic called Ceftriaxone and either liberal or conservative fluids before hospital arrival; the other gets a placebo instead of antibiotics.
What are the potential side effects?
Possible side effects from Ceftriaxone include allergic reactions like rash or itching, gastrointestinal issues such as nausea and diarrhea; Liberal fluid administration may lead to swelling due to excess fluid in the body.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I am 18 years old or older.
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I have sepsis with suspected infection, fever over 38.0°C, and low blood pressure.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I am taking blood thinners.
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I am suspected to have sudden heart failure.
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I have had a Clostridium difficile infection in the past 6 weeks.
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I am experiencing symptoms of fluid retention.
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I am suspected to have had a severe heart attack.
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My identity cannot be confirmed by name or health card.
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I am suspected to have had a stroke recently.
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I have recently experienced a severe injury.
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I am experiencing severe bleeding not caused by an injury.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~during admission
This trial's timeline: 3 weeks for screening, Varies for treatment, and during admission for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
: mortality prior to hospital discharge to day 90.
Secondary study objectives
Frequency distribution and mean time to first dose of antibiotics (if any) within first 24 hours of hospitalization
Microbiology results (if any)
Organ dysfunction during first 24 hours (mechanical ventilation, vasopressor therapy (any), dialysis
+12 more

Awards & Highlights

Pivotal Trial
The final step before approval, pivotal trials feature drugs that have already shown basic safety & efficacy.
All Individual Drugs Already Approved
Therapies where all constituent drugs have already been approved are likely to have better-understood side effect profiles.
Approved for 10 Other Conditions
This treatment demonstrated efficacy for 10 other conditions.
Drug Has Already Been Approved
The FDA has already approved this drug, and is just seeking more data.

Trial Design

4Treatment groups
Experimental Treatment
Active Control
Placebo Group
Group I: Comparison 2: Liberal fluidsExperimental Treatment1 Intervention
Paramedics will administer up to 2 litres of intravenous 0.9% saline solution to all participants in this arm regardless of blood pressure, reassessing for signs of volume overload after each 250ml.
Group II: Comparison 1: Prehospital CeftriaxoneActive Control1 Intervention
1g of Ceftriaxone will be administered by immediate intramuscular (IM) injection. The drug is provided in a sterile and completely covered vial as a white, odourless powder
Group III: Comparison 2: Conservative fluidsActive Control1 Intervention
Paramedics will administer 0.9% saline solution to participants who have systolic blood pressure \<90mmHg, and will only continue the infusion until the systolic blood pressure is \>=100mmHg.
Group IV: Comparison 1: PlaceboPlacebo Group1 Intervention
The placebo is provided in a sterile and completely covered vial.

Find a Location

Who is running the clinical trial?

Canadian Institutes of Health Research (CIHR)OTHER_GOV
1,392 Previous Clinical Trials
26,525,426 Total Patients Enrolled
11 Trials studying Sepsis
8,376 Patients Enrolled for Sepsis
Sunnybrook Research InstituteOTHER
32 Previous Clinical Trials
213,758 Total Patients Enrolled
Dr. Damon ScalesLead Sponsor
Damon Scales, MD PhD FRCPCPrincipal InvestigatorSunnybrook Health Sciences Centre
1 Previous Clinical Trials
200 Total Patients Enrolled

Media Library

Ceftriaxone (Anti-bacterial agent) Clinical Trial Eligibility Overview. Trial Name: NCT03068741 — Phase 4
Sepsis Research Study Groups: Comparison 1: Prehospital Ceftriaxone, Comparison 2: Liberal fluids, Comparison 1: Placebo, Comparison 2: Conservative fluids
Sepsis Clinical Trial 2023: Ceftriaxone Highlights & Side Effects. Trial Name: NCT03068741 — Phase 4
Ceftriaxone (Anti-bacterial agent) 2023 Treatment Timeline for Medical Study. Trial Name: NCT03068741 — Phase 4
~69 spots leftby Mar 2025