Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial
Introduction In conjunction with a beta-lactam, aminoglycosides are the first-choice antibiotic for empirical treatment of sepsis in the neonatal period. The m.1555A>G variant predisposes to ototoxicity after aminoglycoside administration and has a prevalence of 1 in 500. Current genetic test...
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doaj-53288dbec591463faeeb9dd4457cb49a2021-08-07T17:01:54ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-044457Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trialRichard Body0Mark A Turner1William G Newman2John Henry McDermott3Gino Miele4Peter Roberts5Fiona Ulph6Rhona MacLeod7Shaun Ainsworth8Rachel Mahood9Duncan Stoddard10Ajit Mahaveer11Rachel Corry12Julia Garlick13Laura Kemp14Karen Harvey15Nicola Booth16Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK11 Institute of Translational Medicine, Centre for Women's Health Research, Liverpool Women's Hospital, Crown Street, Liverpool, UK Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UKManchester Centre for Genomic, Manchester University NHS Foundation Trust, Manchester, UK 3 Epistem Ltd, Manchester, UK Critical Care, Queen Elizabeth Woolwich, London, UKDivision of Psychology and Mental Health, The University of Manchester, Manchester, UK1Faculty of Medicine and Human Sciences, Institute of Human Development, University of Manchester and Manchester Academic Health Science Centre, Manchester, UK6 genedrive pIc, Manchester, UK Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UKManchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UKNeonatal Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, UKManchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UKManchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UKGenedrive plc, Manchester, UKNeonatal Intensive Care Unit, Liverpool Women's Hospital NHS Foundation Trust, Liverpool, UKNeonatal Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, UKIntroduction In conjunction with a beta-lactam, aminoglycosides are the first-choice antibiotic for empirical treatment of sepsis in the neonatal period. The m.1555A>G variant predisposes to ototoxicity after aminoglycoside administration and has a prevalence of 1 in 500. Current genetic testing can take over 24 hours, an unacceptable delay in the acute setting. This prospective-observational trial will implement a rapid point of care test (POCT), facilitating tailored antibiotic prescribing to avoid hearing loss.Methods and analysis The genedrive POCT can detect the m.1555A>G variant in 26 min from buccal swab. This system will be integrated into the clinical pathways at two large UK neonatal centres over a minimum 6-month period. The primary outcome is the number of neonates successfully tested for the variant out of all babies prescribed antibiotics. As a secondary outcome, clinical timings will be compared with data collected prior to implementation, measuring the impact on routine practice.Ethics and dissemination Approval for the trial was granted by the Research Ethics Committee (REC) and Human Research Authority in August 2019. Results will be published in full on completion of the study.Trial registration number ISRCTN13704894.Protocol version V 1.3.https://bmjopen.bmj.com/content/11/6/e044457.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Richard Body Mark A Turner William G Newman John Henry McDermott Gino Miele Peter Roberts Fiona Ulph Rhona MacLeod Shaun Ainsworth Rachel Mahood Duncan Stoddard Ajit Mahaveer Rachel Corry Julia Garlick Laura Kemp Karen Harvey Nicola Booth |
spellingShingle |
Richard Body Mark A Turner William G Newman John Henry McDermott Gino Miele Peter Roberts Fiona Ulph Rhona MacLeod Shaun Ainsworth Rachel Mahood Duncan Stoddard Ajit Mahaveer Rachel Corry Julia Garlick Laura Kemp Karen Harvey Nicola Booth Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial BMJ Open |
author_facet |
Richard Body Mark A Turner William G Newman John Henry McDermott Gino Miele Peter Roberts Fiona Ulph Rhona MacLeod Shaun Ainsworth Rachel Mahood Duncan Stoddard Ajit Mahaveer Rachel Corry Julia Garlick Laura Kemp Karen Harvey Nicola Booth |
author_sort |
Richard Body |
title |
Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial |
title_short |
Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial |
title_full |
Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial |
title_fullStr |
Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial |
title_full_unstemmed |
Pharmacogenetics to Avoid Loss of Hearing (PALOH) trial: a protocol for a prospective observational implementation trial |
title_sort |
pharmacogenetics to avoid loss of hearing (paloh) trial: a protocol for a prospective observational implementation trial |
publisher |
BMJ Publishing Group |
series |
BMJ Open |
issn |
2044-6055 |
publishDate |
2021-06-01 |
description |
Introduction In conjunction with a beta-lactam, aminoglycosides are the first-choice antibiotic for empirical treatment of sepsis in the neonatal period. The m.1555A>G variant predisposes to ototoxicity after aminoglycoside administration and has a prevalence of 1 in 500. Current genetic testing can take over 24 hours, an unacceptable delay in the acute setting. This prospective-observational trial will implement a rapid point of care test (POCT), facilitating tailored antibiotic prescribing to avoid hearing loss.Methods and analysis The genedrive POCT can detect the m.1555A>G variant in 26 min from buccal swab. This system will be integrated into the clinical pathways at two large UK neonatal centres over a minimum 6-month period. The primary outcome is the number of neonates successfully tested for the variant out of all babies prescribed antibiotics. As a secondary outcome, clinical timings will be compared with data collected prior to implementation, measuring the impact on routine practice.Ethics and dissemination Approval for the trial was granted by the Research Ethics Committee (REC) and Human Research Authority in August 2019. Results will be published in full on completion of the study.Trial registration number ISRCTN13704894.Protocol version V 1.3. |
url |
https://bmjopen.bmj.com/content/11/6/e044457.full |
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