STRAWINSKI: An unfavorable outcome after a stroke is associated with nosocomial infections: PCTus-based antibacterial therapy in patients with severe ischemic stroke

Study Description:
The development of stroke-associated infections has a negative influence on the outcome, i.e. the course of the disease after the stroke. The early identification of high-risk patients, made possible by biomarkers, could lead to an improvement of outcomes after a stroke due to the early starting of antibiotic therapy. With this study, we wanted to investigate whether intensive infection monitoring by means of Procalcitonin ultrasensitive (PCTus) not only permits early and targeted treatment with antibiotics, but can also improve the functional outcome after a stroke - in comparison with a standard therapy based on the current guidelines.

This is a multicenter, randomized, double-blind study.

Principle Investigator: Prof. Dr. Andreas Meisel (WG Cerebrovascular Diseases, NCRC, CSB, Neurology CCM)

Registration: This study is registered in the database (NCT01264549).

Course of the study: 12/2010 - 2014

Hotter, B., S. Hoffmann, L. Ulm, C. Meisel, A. Bustamante, J. Montaner, M. Katan, C. J. Smith, and A. Meisel. "External Validation of Five Scores to Predict Stroke-Associated Pneumonia and the Role of Selected Blood Biomarkers." Stroke 52, no. 1 (Jan 2021): 325-30.

Hotter, B., S. Hoffmann, L. Ulm, J. Montaner, A. Bustamante, C. Meisel, and A. Meisel. "Inflammatory and Stress Markers Predicting Pneumonia, Outcome, and Etiology in Patients with Stroke: Biomarkers for Predicting Pneumonia, Functional Outcome, and Death after Stroke." Neurol Neuroimmunol Neuroinflamm 7, no. 3 (May 2020).

Hotter, B., L. Ulm, S. Hoffmann, M. Katan, J. Montaner, A. Bustamante, and A. Meisel. "Selection Bias in Clinical Stroke Trials Depending on Ability to Consent." BMC Neurol 17, no. 1 (Dec 4 2017): 206.

Ulm, L., S. Hoffmann, D. Nabavi, M. Hermans, B. M. Mackert, F. Hamilton, I. Schmehl, G. J. Jungehuelsing, J. Montaner, A. Bustamante, M. Katan, A. Hartmann, S. Ebmeyer, C. Dinter, J. C. Wiemer, S. Hertel, C. Meisel, S. D. Anker, and A. Meisel. "The Randomized Controlled Strawinski Trial: Procalcitonin-Guided Antibiotic Therapy after Stroke." Front Neurol 8 (2017): 153.

Ulm, L., S. Ohlraun, H. Harms, S. Hoffmann, J. Klehmet, S. Ebmeyer, O. Hartmann, C. Meisel, S. D. Anker, and A. Meisel. "Stroke Adverse Outcome Is Associated with Nosocomial Infections (Strawinski): Procalcitonin Ultrasensitive-Guided Antibacterial Therapy in Severe Ischaemic Stroke Patients - Rationale and Protocol for a Randomized Controlled Trial." Int J Stroke 8, no. 7 (Oct 2013): 598-603.