Changing the way antibiotics are given to adult patients with sepsis will save thousands of lives a year globally, according to research which began with seed funding from the RBWH Foundation.

A clinical trial and systematic review have shown that intravenously administering commonly used penicillin-like antibiotics via continuous infusion – instead of multiple short infusions – cures infections and saves lives.

The research is the culmination of a program work over 20 years that began with small studies, some funded by the RBWH Foundation, focusing on dosing, to large clinical trials with multinational collaborators.

“The RBWH Foundation is proud to be associated with such internationally impactful research in which the Royal Brisbane and Women’s Hospital (RBWH) Intensive Care Unit (ICU) played such a significant role,” said RBWH Foundation CEO Simone Garske.

“Our philosophy of seed funding research and enabling clinicians to gather data has and will continue to change world-practice across many medical and Allied Health specialities.”

Director of Metro North Health’s Herston Infectious Diseases Institute (HeIDI) and the University of Queensland’s Centre for Clinical Research (UQCCR) Professor Jason Roberts said the clinical trial of more than 7000 patients tested findings from laboratory studies to deliver the best drug concentration for the bacteria causing the infection.

“We found by delivering these antibiotic doses as a continuous infusion we can maintain the concentration of the antibiotic in a patient’s blood and tissue, and kill bacteria at a greater rate,” Professor Roberts said.

“This simple intervention uses commonly available antibiotics, so even small hospitals in third-world countries can implement the dosing change almost as easily as well-resourced hospitals in developed countries.”

Director of Research and Implementation at Royal Brisbane and Women’s Hospital and UQ researcher Associate Professor Joel Dulhunty said the international trial, BLING (Beta-Lactam Infusion Group) III, was one of the largest ever antibiotic randomised clinical trials.

“The trial was a massive undertaking involving 104 hospitals in 7 countries, more than 130,000 doses of medication and the analysis of 4 million data points,” Dr Dulhunty said.

Program Head, Critical Care at The George Institute Associate Professor Naomi Hammond said the clinical trial data was then used in a systematic review and meta-analysis, combining 18 studies and more than 9000 patients.

“The combined data showed a very significant benefit with the use of a continuous infusion, saving one life for every 26 patients treated,” Dr Hammond said.

Former RBWH Director of the Intensive Care Unit (ICU) and UQCCR Emeritus Professor Jeffrey Lipman said the next step for the research team would be to inform worldwide treatment protocols and guidelines.

“Physicians follow international guidelines when treating sepsis patients, and at the moment these guidelines have a very low certainty of evidence around how to best administer these drugs,” Emeritus Professor Lipman said.

“Thanks to our program of research, treatment protocols and guidelines will now have a very high certainty.

“Given the simple nature of the findings and the conversations we are having between hospitals, we expect most will adopt these changes immediately.”

The BLING III trial was funded by the National Health and Medical Research Council of Australia, the Belgian Healthcare Knowledge Centre (KCE), the Health Research Council of New Zealand, The University of Queensland, University Hospital Nimes, Skane University Hospital, UK National Institute for Health and Care Research.

The BLING III trial involved collaborators from Australia, New Zealand, Malaysia, Sweden, Belgium, France and the UK.