# Biomarker-Guided Antimicrobial optimization to reduce complications from intra-abdominal infections

> **NIH NIH R34** · SURGICAL INFECTION SOCIETY FOUNDATION FOR EDUCATION AND RESEARCH · 2024 · $165,000

## Abstract

Project Summary/Abstract
Intra-abdominal infections continue to be associated with a complication rate of more than 20%, even for
relatively simple cases. In addition, the spread of antimicrobial resistance and the growing number of old or
medically unwell patients portends even worse outcomes in the near future. Although technical advances related
to imaging and surgical techniques over the past several decades have expanded therapeutic possibilities,
insight into the management of antimicrobials for these conditions has lagged behind. Although prior work by
the Surgical Infection Society has led to a shortening of this therapy to generally a fixed duration of five to seven
days, it is biologically implausible that all patients require the exact same duration of therapy. Instead,
individualized, precision medicine should result in a better matching of antimicrobial needs with prescription. In
order to achieve such an improvement, an accurate biomarker to assess ongoing infection requiring extended
antimicrobial therapy is needed.
Serum C-reactive protein (CRP) levels have been shown to be a reliable biomarker for the severity of intra-
abdominal infections, and their normalization over time is associated with a successful outcome, while a
persistently elevated level is associated with failure and need for further interventions. In addition, serial CRP
measurement is now routinely used to diagnose colorectal surgery-related infections including anastomotic
leaks, even before patients become symptomatic. The current proposal is for a planning grant to design and
organize a multicenter, randomized, clinical trial to test the hypothesis that clinicians can use serial CRP
measurements to individualize duration of antimicrobial therapy for intra-abdominal infections, and that this
strategy will result in a lower global rate of complications. The ultimate U01-funded trial will be administered by
the Surgical Infection Society and is projected to include more than 30 enrolling sites with 1958 subjects and
demonstrate a reduction in complication rates from 22% to 17%.
The clinical relevance of this effort relates to the significant reduction in morbidity and mortality for a vulnerable,
infected population. In addition, more precise antimicrobial management in the future will be associated with a
reduction in antimicrobial resistance pressures.

## Key facts

- **NIH application ID:** 10923676
- **Project number:** 1R34AI178842-01A1
- **Recipient organization:** SURGICAL INFECTION SOCIETY FOUNDATION FOR EDUCATION AND RESEARCH
- **Principal Investigator:** Robert G Sawyer
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $165,000
- **Award type:** 1
- **Project period:** 2024-07-18 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10923676

## Citation

> US National Institutes of Health, RePORTER application 10923676, Biomarker-Guided Antimicrobial optimization to reduce complications from intra-abdominal infections (1R34AI178842-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10923676. Licensed CC0.

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