Beta-Lactam InfusioN Group Study
BLING III
A Phase III Randomised Controlled Trial of Continuous Beta-lactam Infusion Compared With Intermittent Beta-lactam Dosing in Critically Ill Patients
1 other identifier
interventional
7,203
7 countries
103
Brief Summary
The purpose of this study is to find out whether continuous infusion of beta-lactam antibiotics or intermittent infusion or beta-lactam antibiotics, offers more health advantages to patients or if there is no difference. The investigators will be looking to see whether patients receiving beta-lactams via one administration method or the other have a better chance of recovering from their illness. They will also be looking at long term outcomes such as quality-of-life and healthcare resource use. Sepsis is caused by toxic substances (toxins) from bacteria and other organism entering the bloodstream from a site of infection. In some people, the infection can progress to sepsis and septic shock where the functions of organs in the body are affected. Patients suffering from sepsis and septic shock are commonly managed in the intensive care unit (ICU) where they are prescribed antibiotics as standard therapy, as well as other therapies to support the functions of the body. Beta-lactam antibiotics are a group of antibiotics commonly used to treat infection in patients with sepsis and septic shock. Currently, beta-lactam antibiotics are most commonly given to patients be intermittent infusions, that is, given at regular intervals throughout 24 hours. New research suggests that giving beta-lactam antibiotics as a continuous infusion may mean that antibiotic concentrations in the blood remain more consistent and may be more effective at killing bacteria. However, the benefit to the patient by giving beta-lactams via continuous infusion has not been tested in a high-quality, large clinical trial.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable sepsis
Started Mar 2018
Longer than P75 for not_applicable sepsis
103 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
June 5, 2017
CompletedFirst Posted
Study publicly available on registry
July 11, 2017
CompletedStudy Start
First participant enrolled
March 26, 2018
CompletedPrimary Completion
Last participant's last visit for primary outcome
April 12, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
June 29, 2023
CompletedDecember 12, 2023
December 1, 2023
5 years
June 5, 2017
December 10, 2023
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
All-cause mortality
Patient mortality status assessed at 90 days after randomisation
90 Days after randomisation
Secondary Outcomes (4)
Clinical Cure
Day 14 post randomisation
New acquisition, colonisation or infection
up to 14 days post randomisation or hospital discharge, whichever is sooner
All cause ICU mortality
up to 90 days
All cause hospital mortality
up to 90 days
Other Outcomes (5)
ICU length of stay
up to 90 days
Hospital length of stay
up to 90 days
Quality of life
90 days after randomisation
- +2 more other outcomes
Study Arms (2)
Continuous Infusion
OTHERThe prescribed Beta-lactam is administered by a continuous infusion.
Intermittent infusion
OTHERthe prescribed Beta-lactam is administered by intermittent infusion over 30 minutes
Interventions
Clinician prescribed beta-lactam antibiotic will be administered via continuous infusion for as long as prescribed whilst in the ICU
Clinician prescribed beta-lactam antibiotic will be administered via intermittent infusion for as long as prescribed whilst in the ICU
Eligibility Criteria
You may qualify if:
- Documented site of infection or strong suspicion of infection
- At the time of the assessment of suitability for the study, the treating physician expects the patient will require treatment in the ICU that extends beyond the next calendar day
- The treating physician has chosen piperacillin-tazobactam or meropenem to treat the episode of infection
- The treating physician is uncertain if administration of the chosen antibiotic by intermittent or continuous infusion is superior
- One or more organ dysfunction entry criteria in the previous 24 hours
- i. Mean arterial pressure \< 60 mmHg for at least 1 hour
- ii. Vasopressors required for \> 4 hours
- iii. Respiratory support using supplemental high flow nasal prongs, continuous positive airway pressure, bilevel positive airway pressure or invasive mechanical ventilation for at least 1 hour
- iv. Serum creatinine concentration \> 220 µmol/L
You may not qualify if:
- Age less than 18 years
- Receipt of piperacillin-tazobactam or meropenem for more than 24 hours during current infectious episode
- Patients who are known or suspected to be pregnant
- Patient has a known allergy to piperacillin-tazobactam or meropenem or penicillin
- Receiving renal replacement therapy at the time of assessment for eligibility
- The treating physician is not committed to provision of advanced life-support, including mechanical ventilation, dialysis and vasopressor administration, for at least the next 48 hours
- Death is deemed imminent and inevitable
- The patient has previously been enrolled in BLING III
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (103)
Bankstown Hospital
Bankstown, New South Wales, 2200, Australia
Blacktown Hospital
Blacktown, New South Wales, 2148, Australia
Royal Prince Alfred Hospital
Camperdown, New South Wales, 2050, Australia
St Vincents Hosptial
Darlinghurst, New South Wales, 2010, Australia
Gosford Hospital
Gosford, New South Wales, 2250, Australia
John Hunter Hospital
New Lambton Heights, New South Wales, 2305, Australia
Royal North Shore Hospital
Saint Leonards, New South Wales, 2065, Australia
St George Hospital
Sydney, New South Wales, Australia
Westmead Hospital
Westmead, New South Wales, 2145, Australia
Royal Darwin Hospital
Casuarina, Northern Territory, 0811, Australia
The Wesley Hospital
Auchenflower, Queensland, 4066, Australia
Royal Brisbane and Women's Hospital
Brisbane, Queensland, Australia
Caboolture Hospital
Caboolture, Queensland, 4510, Australia
Logan Hospital
Meadowbrook, Queensland, 4131, Australia
Redcliffe Hospital
Redcliffe, Queensland, 4020, Australia
Gold Coast University Hospital
Southport, Queensland, 4215, Australia
Princess Alexandra Hospital
Woolloongabba, Queensland, 4102, Australia
The Queen Elizabeth Hospital
Adelaide, South Australia, Australia
Lyell McEwin Hospital
Elizabeth Vale, South Australia, 5112, Australia
Royal Hobart Hospital
Hobart, Tasmania, 7001, Australia
Bendigo Hospital
Bendigo, Victoria, 3550, Australia
Box Hill Hospital - Eastern Health
Box Hill, Victoria, 3128, Australia
Geelong University Hospital
Geelong, Victoria, 3220, Australia
Austin Hospital
Heidelberg, Victoria, 3084, Australia
Royal Melbourne Hospital
Melbourne, Victoria, 3050, Australia
HĂ´pital Erasme
Brussels, Anderlecht, , 1070, Belgium
ZNA Stuivenberg
Antwerp, 2060, Belgium
Universitair ziekenhuis Antwerpen
Antwerp, 2610, Belgium
Universitair ziekenhuis Brussel
Brussels, 1090, Belgium
Civil Hospital Marie Curie
Charleroi, Belgium
Maria Middelares
Ghent, 9000, Belgium
Universitair ziekenhuis Gent
Ghent, 9000, Belgium
Clinique Saint Pierre
Ottignies, 1340, Belgium
Ch Salon de Provence
Salon-de-Provence, Bouche Du Rhone, 13300, France
Nimes University Hospital
Nîmes, Nimes, 30900, France
Centre Hospitalier Henri Duffaut
Avignon, Vaucluse, 84902, France
Brabois
Nancy, France
Poitiers University Hospital
Poitiers, France
Hospital Universiti Sains Malaysia
Kota Bharu, Kelantan, 16150, Malaysia
University Malaya Medical Centre
Kuala Lumpur, Selangor, 59100, Malaysia
Auckland City Hospital - CVICU
Auckland, 1142, New Zealand
Auckland City Hospital - DCCM
Auckland, 1142, New Zealand
Middlmore Hospital
Auckland, New Zealand
Christchurch Hospital
Christchurch, 8011, New Zealand
Waikato Hospital
Hamilton, 3240, New Zealand
Wellington Hospital
Wellington, 6021, New Zealand
Helsingborg Hospital
Helsingborg, 25223, Sweden
Skane Lund University Hospital
Lund, 22242, Sweden
Skane University Malmo Hospital
Malmo, 21421, Sweden
Royal Berkshire Hospital
Reading, Berkshire, RG1 5AN, United Kingdom
Kings College Hospital
London, Brixton, SE5 9RS, United Kingdom
Princess Royal University Hospital
Orpington, Bromley, BR6 8ND, United Kingdom
Stoke Mandeville Hospital
Aylesbury, Buckinghamshire, HP21 8AL, United Kingdom
Milton Keynes University Hospital
Milton Keynes, Buckinghamshire, MK6 5LD, United Kingdom
Countess of Chester Hospital
Chester, Cheshire, CH21UL, United Kingdom
Dorset County Hospital
Dorchester, Dorset, DT1 2JY, United Kingdom
Poole Hospital
Poole, Dorset, BH15 2JB, United Kingdom
University Hospital of North Tees
Stockton-on-Tees, Durham, TS19 8PE, United Kingdom
Ipswich Hospital
Ipswich, East Suffolk, IP4 5PD, United Kingdom
Darent Valley Hospital
Dartford, England, DA28DA, United Kingdom
Maidstone Hospital
Maidstone, England, ME169QQ, United Kingdom
Derriford Hospital
Plymouth, England, PL68DH, United Kingdom
Broomfield Hospital
Chelmsford, Essex, CM1 7ET, United Kingdom
Golden Jubilee National Hospital
Clydebank, Glasgow, G81 4HX, United Kingdom
Royal Bolton Hospital
Bolton, Greater Manchester, BL4 0JR, United Kingdom
Charing Cross Hospital
London, Hammersmith, SW6 8RF, United Kingdom
Basingstoke and North Hampshire Hospital
Basingstoke, Hampshire, RG24 9NA, United Kingdom
Queen Alexandra Hospital
Portsmouth, Hampshire, PO6 3LY, United Kingdom
Southampton General Hospital
Southampton, Hampshire, SO16 6YD, United Kingdom
Royal Hampshire County Hospital
Winchester, Hampshire, SO22 5DG, United Kingdom
Hereford County Hospital
Hereford, Herefordshire, HR1 2ER, United Kingdom
Watford General Hospital
Watford, Hertfordshire, WD18 0HB, United Kingdom
Medway Maritime Hospital
Gillingham, Kent, ME7 5NY, United Kingdom
Kingston Hospital
Kingston upon Thames, Kent, KT2 7QB, United Kingdom
Tunbridge Wells Hospital
Royal Tunbridge Wells, Kent, TN2 4QJ, United Kingdom
Blackpool Victoria Hospital
Blackpool, Lancashire, FY3 8NR, United Kingdom
The Royal Marsden
Chelsea, London, SW3 6JJ, United Kingdom
Guy's & St Thomas' Hospital London
Lambeth, London, SE1 7EH, United Kingdom
St Georges Hospital
Tooting, London, SW17 0QT, United Kingdom
The Royal London Hospital
Whitechapel, London, E1 1BB, United Kingdom
Royal Victoria Infirmary
Newcastle, Northhumberland, NE1 4LP, United Kingdom
Newcastle Freeman Hospital
Newcastle, Northumberland, NE7 7DN, United Kingdom
The Queens Medical Centre
Nottingham, Nottinghamshire, NG7 2UH, United Kingdom
Kingsmill Hospital
Sutton in Ashfield, Nottinghamshire, NG17 4JL, United Kingdom
St Marys Hospital
London, Paddington, W2 1NY, United Kingdom
Whiston Hospital
Rainhill, Prescot, L35 5DR, United Kingdom
Hammersmith Hospital
London, Shepherds Bush, W12 0HS,, United Kingdom
James Cook University Hospital South Tees
Middlesbrough, South Tees, TS4 3BW, United Kingdom
Frimley Park Hospital
Frimley, Surrey, GU16 7UJ, United Kingdom
Royal Surrey County Hospital
Guildford, Surrey, GU2 7XX, United Kingdom
Sunderland Royal Hospital
Sunderland, Tyne and Wear, SR4 7TP, United Kingdom
University Hospital of Wales
Cardiff, Wales, CF14 4XW, United Kingdom
University Hospital Coventry & Warwickshire
Coventry, Warwickshire, CV2 2DX, United Kingdom
Queen Elizabeth Medical Centre
Birmingham, West Midlands, B12 2TH, United Kingdom
Pinderfields General Hospital
Wakefield, West Yorkshire, WF1 4DG, United Kingdom
Bristol Royal Infirmary
Bristol, BS1 3NU, United Kingdom
Northumbria Specialist Emergency Hospital
Cramlington, United Kingdom
Ninewells Hospital
Dundee, United Kingdom
Glasgow Royal Infirmary
Glasgow, United Kingdom
Hull Royal Infirmary
Hull, HU3 2JZ, United Kingdom
Whittington Health
London, N19 5NF, United Kingdom
Queen's Hospital
Romford, United Kingdom
Salford Royal Hospital
Salford, M6 8HD, United Kingdom
Related Publications (2)
Dulhunty JM, Brett SJ, De Waele JJ, Rajbhandari D, Billot L, Cotta MO, Davis JS, Finfer S, Hammond NE, Knowles S, Liu X, McGuinness S, Mysore J, Paterson DL, Peake S, Rhodes A, Roberts JA, Roger C, Shirwadkar C, Starr T, Taylor C, Myburgh JA, Lipman J; BLING III Study Investigators. Continuous vs Intermittent beta-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. JAMA. 2024 Aug 27;332(8):629-637. doi: 10.1001/jama.2024.9779.
PMID: 38864155DERIVEDLipman J, Brett SJ, De Waele JJ, Cotta MO, Davis JS, Finfer S, Glass P, Knowles S, McGuinness S, Myburgh J, Paterson DL, Peake S, Rajbhandari D, Rhodes A, Roberts JA, Shirwadkar C, Starr T, Taylor C, Billot L, Dulhunty JM. A protocol for a phase 3 multicentre randomised controlled trial of continuous versus intermittent beta-lactam antibiotic infusion in critically ill patients with sepsis: BLING III. Crit Care Resusc. 2019 Mar;21(1):63-68.
PMID: 30857514DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- STUDY CHAIR
Jeffrey Lipman
The George Institute
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 5, 2017
First Posted
July 11, 2017
Study Start
March 26, 2018
Primary Completion
April 12, 2023
Study Completion
June 29, 2023
Last Updated
December 12, 2023
Record last verified: 2023-12