A major UK-wide study, led by Newcastle University, is investigating whether a shorter course of antibiotics could be just as safe and effective for sepsis treatment as the current standard.
The research, known as the SHORTER trial, is testing if a five-day antibiotic regimen is as effective as the usual seven-day course.
If successful, this could revolutionise how sepsis is managed in hospitals, reducing risks for patients while tackling a major global health threat – antibiotic resistance.
The dangers of sepsis
Sepsis is a life-threatening reaction that occurs when the body’s immune system goes into overdrive in response to an infection.
Instead of fighting the illness, the immune system begins to damage tissues and organs. Without rapid diagnosis and treatment, sepsis can lead to organ failure and death.
Globally, it affects millions of people each year, making it one of the most urgent medical emergencies.
Why antibiotic duration matters
Antibiotics are the cornerstone of sepsis treatment. They are started immediately once the condition is suspected, as every hour of delay can increase the risk of death.
But despite their importance, the exact length of treatment needed for sepsis remains unclear. Current practice often relies on seven-day courses, though research into other infections has suggested shorter regimens can be equally effective.
By testing a five-day course, the SHORTER trial aims to identify whether patients can be safely treated in less time, reducing unnecessary exposure to antibiotics without compromising recovery.
The growing danger of antibiotic resistance
One of the biggest concerns in modern healthcare is antibiotic resistance. This happens when bacteria evolve to survive the drugs designed to kill them, creating so-called ‘superbugs.’
Resistant infections are harder to treat, often requiring stronger or multiple antibiotics, and in some cases can be fatal.
Overuse and misuse of antibiotics accelerate this problem. Prescribing antibiotics for longer than necessary provides bacteria with more opportunities to adapt, fuelling resistance.
By reducing the length of antibiotic use where safe, the SHORTER trial aims to protect both current and future patients.
A national effort in critical care
The SHORTER trial is funded by the National Institute for Health and Care Research and is being coordinated by Newcastle University’s Clinical Trials Unit. It involves 47 hospitals across the UK, with over 800 patients already enrolled.
Hospital staff in intensive care units are closely monitoring outcomes to determine whether shorter antibiotic courses provide the same level of protection. The findings could shape future guidelines for sepsis treatment worldwide.
Dr Tom Hellyer, clinical senior lecturer at Newcastle University and honorary consultant in critical care medicine at Newcastle Hospitals, is chief investigator for the trial.
He commented: “Striking the right balance of using antibiotics appropriately, while avoiding potential harm, can be challenging.
“Antibiotics are started quickly for sepsis because of the severity of the illness, but the exact duration needed to treat the infection is currently unknown.
“We hope that the SHORTER trial will help to determine the safest and effective use of antibiotics for patients with this condition.”
If the trial proves that shorter courses are safe, it could bring dual benefits: saving lives through effective sepsis treatment while reducing the growing threat of antibiotic resistance.
With results from the trial expected in the coming years, Newcastle’s leadership in this research could transform how one of medicine’s most urgent emergencies is treated.