Skip to main content

PREADAPT-Sepsis

Lay summary

Procalcitonin and C-reactive protein are biomarkers, which are naturally occurring substances within the human body. Levels increase in response to bacterial infection, and reduce with effective antibiotic treatment. High quantities in the bloodstream are associated with a diagnosis of sepsis. Testing the levels of these biomarkers can help to guide the length of antibiotic treatment needed. The ADAPT Sepsis randomised clinical trial found out that daily testing of procalcitonin to guide antibiotic duration is effective and safe for patients when compared with standard hospital care.
Our study, PREADAPT-Sepsis, used a type of research method called a process evaluation. It was carried out at the same time as the clinical trial, and focused on the hospital staff. When the clinical team received biomarker test results they made a decision about whether to start, continue or stop prescribing antibiotics. They had to use their professional judgement to make this decision, which can be influenced by many different factors. We used questionnaires and interviews to find out how they made their decisions, and to learn why they might or might not use the biomarker test results.

We have sent our findings to be published in a scientific journal, and will share a link on this project page when they are publicly available.

Study details

  • Full title: Process evaluation of the ADAPT-Sepsis trial using mixed methods to investigate factors influencing implementation of biomarker-guided antibiotic prescribing in suspected sepsis.
  • Study design: Mixed methods process evaluation (implementation) study
  • Chief Investigator: Ruth Louise Poole
  • Sponsor: Cardiff and Vale University Health Board
  • Sponsor ref: 18/JUL/7475
  • Funding: Intensive Care Society / National Institute for Health and Care Excellence (NICE)
  • ResearchRegistry.com ID: ResearchRegistry4244

Publications

  • Dark P, Hossain A, McAuley DF, Poole RL, et al. Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial. JAMA. 2025;333(8):682–693. doi:10.1001/jama.2024.26458.

We have also presented some of our associated work at meetings and conferences, including:

  • Poole R.L., Lloydwin C., White J., Dark, P. (2025) The changing landscape of biomarker-guided antibiotic prescribing for suspected sepsis: Usage of procalcitonin and C-reactive protein in the UK. Intensive Care Society State of the Art Congress, Birmingham, UK, July 2025 [oral e-poster presentation].
  • Poole R.L. (2019) Diagnostic testing for sepsis: procalcitonin. “What do people, NICE and industry want from medical devices?”, Royal Society of Medicine, London, UK, December 2019 [oral presentation].
  • Poole R.L., O’Connell, Laight T., Carolan-Rees G. (2019) Exploring the long-term impact of post-sepsis syndrome. Health Services Research UK, Manchester, UK, July 2019 [rapid-fire oral and poster presentation; abstract 172].
  • Poole R.L., Blackwood B., Dark P.M. (2017)  PREADAPT-Sepsis PRocess Evaluation of the ADAPT-Sepsis trial: new study proposal. UK Critical Care Research Forum, Birmingham, UK, June 2017 [oral presentation].