Optimal duration of antibiotic therapy to prevent infections in patients undergoing cardiac surgery

Optimal duration of antibiotic therapy to prevent infections in patients undergoing cardiac surgery

 

CALIPSO trial: The Duration of Cardiac Antimicrobial Prophylaxis Outcomes Study

CALIPSO is a large (n=9,180) five year, multicentre, adaptive, pragmatic, double-blind, three-arm, placebo-controlled, randomised, non-inferiority clinical trial examining the optimal duration of antibiotic therapy to prevent infections in patients undergoing cardiac surgery.

The trial aims to compare the incidence of surgical site infection (and other healthcare associated infections), health economic and microbiological impact after intraoperative only (Arm A), to 24 hours (Arm B) and, to 48 hours (Arm C) of IV cefazolin and placebo postoperative surgical antimicrobial prophylaxis.

The team is led by Professor Trisha Peel, and founding Chair of the ANZCA CTN Professor Paul Myles. The trial is funded by a $7.9 million grant from the Medical Research Future Fund.

Please email Paige Druce if you are at all interested in being involved, with your contact details and any questions.

Principal investigators

Professor Trisha Peel (CIA) and Professor Paul Myles (CIB) (Monash University and Alfred Health)

Expression of Interest

Please email Paige Druce if you are interested in being involved, or would like any further information about CALIPSO.

Start-up meeting

The start-up meeting was held at the ANZCA CTN workshop in August 2022. To obtain a copy of the recording, email Paige Druce.

 

Trial summary

Study summary
The CALIPSO trial is a multicentre, adaptive, pragmatic, double-blind, three-arm, placebo-controlled, randomised, non-inferiority clinical trial comparing the incidence of surgical site infection after intraoperative only (Arm A), to 24 hours (Arm B) and, to 48 hours (Arm C) of IV cefazolin and placebo postoperative surgical antimicrobial prophylaxis in patients undergoing cardiac surgery.

Eligibility
Adult patients scheduled for cardiac surgery involving a median sternotomy.

Study intervention
A bolus of study drug (2g cefazolin or matched placebo) administered every 8-hours following the preoperative dose (time=0) for a total of five postoperative doses.

Primary endpoint
Incidence of surgical site infection.

Secondary endpoints
Clostridioides difficile infection, other healthcare associated infections (pneumonia, blood stream infection and urinary tract infection), health economic endpoints (​​days alive and at home at 30, 90 and 180 days after surgery, direct health care costs, Quality of life data (EQ-5D-5L) at 180 days), microbiological impact.

Safety endpoints

Antimicrobial hypersensitivity reactions, all-cause mortality at 180 days, surgical site infections due to drug-resistant infections (defined as resistance to cefazolin) and, acute kidney injury.

Sample size
9180 patients.

Study duration
Five years.

Funding

Medical Research Future Fund grant $A7,979,999.10 (2022-2027)

Operations Committee

A/Prof Trisha Peel
Dr Andrew Stewardson
Ms Paige Druce
Ms Sarah Astbury
Ms Janine Roney

Collaborators and endorsements

Monash University, Melbourne (Administering institution)
Alfred Health, Melbourne
Australian and New Zealand College of Anaesthetists Clinical Trials Network (ANZCA CTN)
Australian and New Zealand Intensive Care Society Clincal Trials Group (ANZICS CTG)
The Australasian Society for Infectious Diseases (ASID)
The Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS)

Progress

The CALIPSO trial opened to recruitment in February 2023 and has since recruited over 1,047 patients at hospital sites across Australia and New Zealand. The trial is expanding internationally with ethics processes underway for sites in South Africa, Italy (and elsewhere in Europe), Canada and the US.

Media releases

Participating hospitals

Australian sites
Alfred Health VIC
Austin Health VIC
Cabrini Hospital VIC
Epworth Richmond VIC
Fiona Stanley Hospital WA
Flinders Medical Centre SA
Flinders Private Hospital SA
Prince Charles Hospital QLD
Princess Alexandra Hospital QLD
Royal Adelaide Hospital SA
Royal Hobart Hospital TAS
Royal Melbourne Hospital VIC
SJOG Subiaco WA
Sir Charles Gairdner Hospital WA
St Andrew’s Hospital QLD
St George Hospital NSW
St John of God Subiaco WA
St Vincent’s Hospital Melbourne VIC
The Victorian Heart Hospital VIC
Westmead Hospital NSW
New Zealand Hospitals
Christchurch Hospital
Waikato
Wellington Hospital

Trial registration

Last updated 15:18 13.11.2024