Current Studies

REMAP-CAP (non COVID)

Inclusion Criteria:

To participate in this trial, a patient must meet both of the following criteria:

1. Adult patient admitted to an ICU for acute severe CAP within 48 hours of hospital admission with

a. symptoms or signs or both that are consistent with lower respiratory tract infection (for example, acute onset of dyspnea, cough, pleuritic chest pain)

AND

b. Radiological evidence of new onset infiltrate of infective origin (in patients with preexisting radiological changes, evidence of new infiltrate)

2. Up to 48 hours after ICU admission, receiving organ support with one or more of:

a. Non-invasive or invasive ventilatory support;
b. Receiving infusion of vasopressor or inotropes or both

REMAP CAP COVID 19

Does the patient have clinically suspected or proven pandemic infection?

• Clinically suspected = treating clinician believes that pandemic infection is a likely diagnosis
• That testing is being done is not sufficient, must think pandemic infection is likely
• Suspected or proven hospital-acquired pandemic infection are eligible

REMAP COVID 19 Inclusion Criteria

To participate in this trial, a patient must meet both of the following criteria:

Adult patient admitted to an ICU (an area that is capable of providing ICU level care) for

• COVID-19 infection is suspected by the treating clinician or has been confirmed by microbiological testing
• Microbiological testing for SARS-CoV-2 infection of upper or lower respiratory tract secretions or both has occurred or is intended to occur Domain
• NIV with a sealed mask, High Flow, invasive mechanical ventilation, or vasopressors via continuous infusion

REMAP COVID 19 Exclusion Criteria

Patients will be excluded from this domain if they have any of the following:

• More than 24 hours has elapsed since ICU admission
• In areas where MERS-CoV infection is endemic, the patient has laboratory confirmed MERS-CoV infection
• The treating clinician believes that participation in the domain would not be in the best interests of the patient

How to randomise:

https://remapcap.spinnakersoftware.com/Home/

Username: SVHICU1234 Password: SVHICU1234

Each separate domain has a domain specific appendix which can be found in this folder, more in depth exclusion criteria and dosing guidance can be found in these

REMAP-CAP: Antibiotic Domain Summary

• Ceftriaxone + Macrolide
• Moxifloxacin
• Amoxicillin-clavulanate + Macrolide

All patients receiving ceftriaxone, or amoxicillin-clavulanate will also receive a macrolide

REMAP-CAP: Macrolide Duration Domain Summary

• Standard course macrolide discontinued after 3 to 5 days unless there is confirmed or strongly suspected microbiological cause for prolonged administration
• Extended course macrolide for 14 days or hospital discharge, whichever occurs first IV azithromycin, with switch to enteral azithromycin when appropriate

REMAP-CAP: Corticosteroid Domain Summary

• Fixed duration hydrocortisone for 7 days
• Shock-dependent hydrocortisone while the patient is in septic shock

REMAP-CAP: COVID-19 Antiviral Therapy Domain Summary

• No antiviral for COVID-19 (no placebo)
• Lopinavir/ritonavir (Kaletra)

REMAP-CAP: COVID-19 Immune Modulation Therapy Domain Summary

• No immune modulation for COVID-19 (no placebo)
• Interferon-beta-1a (IFN-β-1a)