The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study

Introduction The intraoperative administration of dexamethasone for prophylaxis against postoperative nausea and vomiting is a common and recommended practice. The safety of the administration of this immunosuppressive agent at a time of significant immunological disruption has not been rigorously e...

Full description

Saved in:
Bibliographic Details
Main Authors: David Story, Allen C Cheng, Andrew B Forbes, Kate Leslie, Tomás B Corcoran, Paul S Myles, Ed O'Loughlin, Timothy G Short, Matthew TV Chan, Pauline Coutts, Jaspreet Sidhu, Leon A Bach, Kwok M Ho, Chris Frampton, Richard Macisaac, Michael Paech, Bala Venkatesh, Leon Worth, Stephane Heritier, Cathy Martin, Roger Browning, Emma Hamilton, Paul Ingram, Peter Boan
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/9/e030402.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850269960384806912
author David Story
Allen C Cheng
Andrew B Forbes
Kate Leslie
Tomás B Corcoran
Paul S Myles
Ed O'Loughlin
Timothy G Short
Matthew TV Chan
Pauline Coutts
Jaspreet Sidhu
Leon A Bach
Kwok M Ho
Chris Frampton
Richard Macisaac
Michael Paech
Bala Venkatesh
Leon Worth
Stephane Heritier
Cathy Martin
Roger Browning
Emma Hamilton
Paul Ingram
Peter Boan
author_facet David Story
Allen C Cheng
Andrew B Forbes
Kate Leslie
Tomás B Corcoran
Paul S Myles
Ed O'Loughlin
Timothy G Short
Matthew TV Chan
Pauline Coutts
Jaspreet Sidhu
Leon A Bach
Kwok M Ho
Chris Frampton
Richard Macisaac
Michael Paech
Bala Venkatesh
Leon Worth
Stephane Heritier
Cathy Martin
Roger Browning
Emma Hamilton
Paul Ingram
Peter Boan
author_sort David Story
collection DOAJ
description Introduction The intraoperative administration of dexamethasone for prophylaxis against postoperative nausea and vomiting is a common and recommended practice. The safety of the administration of this immunosuppressive agent at a time of significant immunological disruption has not been rigorously evaluated in terms of infective complications.Methods/analysis This is a pragmatic, multicentre, randomised, controlled, non-inferiority trial. A total of 8880 patients undergoing elective major surgery will be enrolled. Participants will be randomly allocated to receive either dexamethasone 8 mg or placebo intravenously following the induction of anaesthesia in a 1:1 ratio, stratified by centre and diabetes status. Patient enrolment into the trial is ongoing. The primary outcome is surgical site infection at 30 days following surgery, defined according to the Centre for Disease Control criteria.Ethics/dissemination The PADDI trial has been approved by the ethics committees of over 45 participating sites in Australia, New Zealand, Hong Kong, South Africa and the Netherlands. The trial has been endorsed by the Australia and New Zealand College of Anaesthetists Clinical Trials Network and the Australian Society for Infectious Diseases Clinical Research Network. Participant recruitment began in March 2016 and is expected to be complete in mid-2019. Publication of the results of the PADDI trial is anticipated to occur in early 2020.Trial registration number ACTRN12614001226695.
format Article
id doaj-art-b3c67b47198d4e68bd0570e7545da3e3
institution OA Journals
issn 2044-6055
language English
publishDate 2019-09-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-b3c67b47198d4e68bd0570e7545da3e32025-08-20T01:52:50ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-030402The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority studyDavid Story0Allen C Cheng1Andrew B Forbes2Kate Leslie3Tomás B Corcoran4Paul S Myles5Ed O'Loughlin6Timothy G Short7Matthew TV Chan8Pauline Coutts9Jaspreet Sidhu10Leon A Bach11Kwok M Ho12Chris Frampton13Richard MacisaacMichael PaechBala VenkateshLeon WorthStephane HeritierCathy MartinRoger BrowningEmma Hamilton14Paul IngramPeter BoanPerioperative and Pain Medicine Unit, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia4 Alfred Hospital, Melbourne, Victoria, Australia1 School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, AustraliaDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia1 Royal Perth Hospital, Perth, Western Australia, AustraliaAnaesthesia and Perioperative Medicine, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia2 University of Western Australia, Perth, Western Australia, Australia8 Auckland City Hospital, Grafton, Auckland, New ZealandDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China1 Royal Perth Hospital, Perth, Western Australia, Australia3 Monash University, Melbourne, Victoria, Australia3 Monash University, Melbourne, Victoria, Australia2 University of Western Australia, Perth, Western Australia, Australia6 Department of Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand16 Scottish Drug Forum, Edinburgh, UKIntroduction The intraoperative administration of dexamethasone for prophylaxis against postoperative nausea and vomiting is a common and recommended practice. The safety of the administration of this immunosuppressive agent at a time of significant immunological disruption has not been rigorously evaluated in terms of infective complications.Methods/analysis This is a pragmatic, multicentre, randomised, controlled, non-inferiority trial. A total of 8880 patients undergoing elective major surgery will be enrolled. Participants will be randomly allocated to receive either dexamethasone 8 mg or placebo intravenously following the induction of anaesthesia in a 1:1 ratio, stratified by centre and diabetes status. Patient enrolment into the trial is ongoing. The primary outcome is surgical site infection at 30 days following surgery, defined according to the Centre for Disease Control criteria.Ethics/dissemination The PADDI trial has been approved by the ethics committees of over 45 participating sites in Australia, New Zealand, Hong Kong, South Africa and the Netherlands. The trial has been endorsed by the Australia and New Zealand College of Anaesthetists Clinical Trials Network and the Australian Society for Infectious Diseases Clinical Research Network. Participant recruitment began in March 2016 and is expected to be complete in mid-2019. Publication of the results of the PADDI trial is anticipated to occur in early 2020.Trial registration number ACTRN12614001226695.https://bmjopen.bmj.com/content/9/9/e030402.full
spellingShingle David Story
Allen C Cheng
Andrew B Forbes
Kate Leslie
Tomás B Corcoran
Paul S Myles
Ed O'Loughlin
Timothy G Short
Matthew TV Chan
Pauline Coutts
Jaspreet Sidhu
Leon A Bach
Kwok M Ho
Chris Frampton
Richard Macisaac
Michael Paech
Bala Venkatesh
Leon Worth
Stephane Heritier
Cathy Martin
Roger Browning
Emma Hamilton
Paul Ingram
Peter Boan
The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study
BMJ Open
title The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study
title_full The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study
title_fullStr The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study
title_full_unstemmed The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study
title_short The perioperative administration of dexamethasone and infection (PADDI) trial protocol: rationale and design of a pragmatic multicentre non-inferiority study
title_sort perioperative administration of dexamethasone and infection paddi trial protocol rationale and design of a pragmatic multicentre non inferiority study
url https://bmjopen.bmj.com/content/9/9/e030402.full
work_keys_str_mv AT davidstory theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT allenccheng theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT andrewbforbes theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT kateleslie theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT tomasbcorcoran theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT paulsmyles theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT edoloughlin theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT timothygshort theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT matthewtvchan theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT paulinecoutts theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT jaspreetsidhu theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT leonabach theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT kwokmho theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT chrisframpton theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT richardmacisaac theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT michaelpaech theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT balavenkatesh theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT leonworth theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT stephaneheritier theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT cathymartin theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT rogerbrowning theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT emmahamilton theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT paulingram theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT peterboan theperioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT davidstory perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT allenccheng perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT andrewbforbes perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT kateleslie perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT tomasbcorcoran perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT paulsmyles perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT edoloughlin perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT timothygshort perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT matthewtvchan perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT paulinecoutts perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT jaspreetsidhu perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT leonabach perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT kwokmho perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT chrisframpton perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT richardmacisaac perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT michaelpaech perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT balavenkatesh perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT leonworth perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT stephaneheritier perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT cathymartin perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT rogerbrowning perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT emmahamilton perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT paulingram perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy
AT peterboan perioperativeadministrationofdexamethasoneandinfectionpadditrialprotocolrationaleanddesignofapragmaticmulticentrenoninferioritystudy