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Contact Information:

Dr Study Team
-
easystudy@nictu.hscni.net


Dr Thomas Waterfield
+44 (0)7872990521
t.waterfield@qub.ac.uk


More information about this study, what is involved and how to take part can be found on the study website.

Study Location:

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Be Part of Research - Trial Details - Empirical oral AntibioticS for possible urinary tract infection (UTI) in well-appearing Young febrile infants (EASY)

Empirical oral AntibioticS for possible urinary tract infection (UTI) in well-appearing Young febrile infants (EASY)

Medical Conditions

Urinary tract infection (UTI)


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


Children between 1 and 3 months of age with a fever (raised body temperature) commonly undergo blood and urine tests to check for infection. They are admitted to the hospital for a minimum of 36 to 48 hours to wait for the results of their laboratory tests for infection and given intravenous antibiotics "just in case" while waiting for these results. Laboratory tests for infection involve watching to see if bacteria grow in the blood and urine samples for 36 to 48 hours. As well as these slow tests for infection, babies will usually also have some rapid tests done on a blood sample (that take a few hours) which are used to help assess how unwell a baby is. The most common infection requiring treatment with antibiotics, in babies aged 1 to 3 months is a urinary tract infection (UTI). These infections usually respond quickly to antibiotic treatment but can be difficult to diagnose. When doctors are unsure if there is a UTI, they often give intravenous antibiotics until the results of the laboratory tests for infection are available, which is typically 36 to 48 hours later. Research has shown that babies aged between 1 and 3 months who appear well and have reassuring results from rapid blood tests can be treated with oral antibiotics. Likewise, several international guidelines have been published that recommend oral antibiotics as first-line treatment for infants with a suspected UTI. The EASY study aims to determine if babies with a suspected UTI can be treated with oral antibiotics whilst they wait for their laboratory results. This approach has the potential to reduce the need for painful procedures such as injections, reduce hospital admissions with its associated stress for parents/guardians and reduce healthcare costs.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

01 May 2024 12 Mar 2025

Participants will be randomly allocated into two groups:
Oral antibiotics and continuation of oral treatment at least until urine culture results are known (typically after 36 to 48 hours).
Continuation of parenteral antibiotics (standard care) at least until urine culture results are known (typically after 36 to 48 hours).


Children aged 29 to 90 days old (infants from their 29th day of life to their 90th day of life inclusive) with suspected urinary tract infection (UTI) requiring treatment with antibiotics

You can take part if:



You may not be able to take part if:


Current participant exclusion criteria as of 18/12/2024: 1. Born at <30 weeks gestation 2. Discharged from hospital more than 7 days after birth 3. History of re-admission to hospital that required treatment with parenteral antibiotics 4. Known or suspected structural renal abnormality 5. Evidence of sepsis and/or meningitis (appear unwell, shock, hypotension, altered mental state, bulging fontanelle, lumbar puncture suggestive of bacterial meningitis) 6. Received vaccination within 48 hours of attendance

_____

Previous participant exclusion criteria as of 30/04/2024 to 18/12/2024: 1. Born at <30 weeks gestation2. Discharged from hospital more than 7 days after birth3. Required re-admission to hospital after birth for more than 24 hours4. Known or suspected structural renal abnormality5. Evidence of sepsis and/or meningitis (appear unwell, shock, hypotension, altered mental state, bulging fontanelle, lumbar puncture suggestive of bacterial meningitis)6. Received vaccination within 48 hours of attendance7. Sodium < 128mmol/l on lab or blood gas sample8. Potassium > 6.5 mmol/l on lab sample9. Plasma creatinine > 50 micromol/l10. Inability to tolerate oral medication11. Urine sample was not sent for culture12. Received additional antibiotics (with the exception of the parenteral antibiotic administered within 24 hours of hospital attendance)13. Declined consent for participation

_____

Previous participant exclusion criteria:1. Born at <30 weeks gestation2. Discharged from hospital more than 7 days after birth3. Required re-admission to hospital after birth for more than 24 hours4. Known or suspected structural renal abnormality 5. Evidence of sepsis and/or meningitis (appear unwell, shock, hypotension, altered mental state, bulging fontanelle, lumbar puncture suggestive of bacterial meningitis)6. Received vaccination within 48 hours of attendance7. Sodium < 128mmol/l on lab or blood gas sample8. Potassium > 6.5 mmol/l on lab or blood gas sample9. Plasma creatinine > 50 micromol/l10. Inability to tolerate oral medication11. Urine sample was not sent for culture12. Received additional antibiotics (with the exception of the parenteral antibiotic administered during initial emergency care)13. Declined consent for participation


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • Musgrove Park Hospital (taunton)
    Musgrove Park Hospital
    Taunton
    TA1 5DA
  • Birmingham Childrens Hospital
    Steelhouse Lane
    Birmingham
    B4 6NH
  • Ninewells Hospital
    Ninewells Avenue
    Dundee
    DD1 9SY
  • University Hospital of Wales
    Heath Park
    Cardiff
    CF14 4XW
  • Royal Berkshire Hospital
    London Road
    Reading
    RG1 5AN
  • Addenbrookes
    Addenbrookes Hospital Hills Road
    Cambridge
    CB2 0QQ
  • Leicester Royal Infirmary
    Infirmary Square
    Leicester
    LE1 5WW
  • The Royal Belfast Hospital for Sick Children
    274 Grosvenor Road
    Belfast
    BT12 6BA
  • University Hospital Southampton
    Southampton University Hospital Tremona Road
    Southampton
    SO16 6YD
  • Sunderland Royal Hospital
    Kayll Road
    Sunderland
    SR4 7TP
  • Royal Cornwall Hospital (treliske)
    Treliske
    Truro
    TR1 3LJ
  • Poole Hospital
    Longfleet Road
    Poole
    BH15 2JB
  • Sheffield Childrens Hospital
    Western Bank
    Sheffield
    S10 2TH
  • Countess of Chester Hospital
    Countess of Chester Health Park Liverpool Road
    Chester
    CH2 1UL
  • Peterborough City Hospital
    Edith Cavell Campus Bretton Gate Bretton
    Peterborough
    PE3 9GZ
  • Queens Medical Centre, Nottingham University Hospital
    Derby Road
    Nottingham
    NG7 2UH
  • Bristol Royal Hospital for Children
    Upper Maudlin Street
    Bristol
    BS2 8BJ
  • James Cook Hospital
    Marton Road
    Middlesbrough
    TS4 3BW
  • Alder Hey Childrens Hospital
    Eaton Road West Derby
    Liverpool
    L12 2AP
  • Oxford Children’s Hospital
    John Radcliffe Hospital Headington
    Oxford
    OX3 0AG
  • St Mary's Hospital
    Imperial College London, St. Mary's Campus, Medical School, Room 231, Norfolk Place
    London
    W2 1PG
  • Salisbury District Hospital Laboratory
    Salisbury District Hospital Odstock Road
    Salisbury
    SP2 8BJ

It is considered that the risk associated with the antibiotics proposed for use within the EASY study is no higher than the risk of standard care. The oral and parenteral antibiotics will be used within the terms of their marketing authorisation and local prescribing protocols.
If the participant is allocated to intravenous antibiotics they will receive the same antibiotic treatment infants receive when they present to the hospital with suspected urinary tract infection (standard care). The initial insertion of an intravenous line involves some discomfort but this is usually mild. Intravenous lines have a small risk of becoming infected themselves and very occasionally can cause irritation in the vein. If this happened the line would be removed. As it is currently standard practice to give antibiotics intravenously for febrile infants with a suspected urinary tract infection, these risks are no different whether the parent/guardian agrees that their child should participate in the study or not. Complications of peripheral venous access such as extravasation injury, tissued lines and line infections will be reported as adverse events (AEs).
Both oral and intravenous antibiotics may cause diarrhoea or rash. In general oral antibiotics are more likely to cause nausea and vomiting than antibiotics given by injection. There is a risk for children in the oral antibiotic group that their infection may not resolve as quickly compared with those who continue on intravenous antibiotics. This might require a change of antibiotics or a switch back to intravenous antibiotics. If discharged home, there is a small chance they may need to come back to the hospital and possibly be readmitted if doctors feel their infection is not settling or they are becoming more unwell.
Where the participant has been discharged from the hospital, follow-up assessments will be performed via telephone 24 hours after randomisation, 36-48 hours, day 7 and day 28, asking the parent/guardian to report if their child has an ongoing fever or other symptoms of concern. Symptom data will be monitored remotely during trial follow-up by the local clinical team. If there are any concerns parents/guardians will be advised to attend the emergency department so that a medical review can be undertaken. Parents/guardians will be provided with a dedicated telephone contact number, allowing direct access to the local clinical team between 8 am – 8 pm Monday to Friday. Parents/guardians will be provided with a telephone contact number for the paediatric emergency department at the local site, which can be used at all other times, should they have any questions or concerns. Parents/guardians will be advised to attend the emergency department at any time, should they have any questions or concerns.

Dr Study Team
-
easystudy@nictu.hscni.net


Dr Thomas Waterfield
+44 (0)7872990521
t.waterfield@qub.ac.uk



More information about this study, what is involved and how to take part can be found on the study website.


The study is sponsored by Belfast Health and Social Care Trust and funded by Health Technology Assessment Programme.




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Read full details for Trial ID: ISRCTN10907780

Or CPMS 61097

Last updated 14 April 2025

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