This study involves patients with severe acute infection, which is a serious condition where harmful germs such as bacteria or viruses invade the body and cause widespread illness that can affect multiple organs. The study will use four different medications that may be given based on individual patient needs: hydrocortisone (a steroid medication that helps reduce inflammation and supports the body’s stress response, available as tablets or injection), acetylcysteine (a medication given through a vein that helps protect organs from damage), and ferric derisomaltose (an iron supplement given through a vein to treat low iron levels in the blood). The purpose of the study is to determine if a treatment approach tailored to each patient’s specific needs can reduce the number of deaths and shorten the time patients spend in the hospital.
Patients in this study will be adults admitted to the hospital with suspected infection who show signs that their organs are not working properly. They must have been admitted within 72 hours with an infection that doctors expect will require hospital care for more than 24 hours. The study will compare patients who receive individualized treatment based on their specific medical problems against those who receive standard care. The treatments may be given alone or in combination depending on what each patient needs, and the treatment period can last up to 8 days for some medications and 1 day for others.
During the study, doctors will monitor patients closely for any side effects and will track how many days patients are alive and out of the hospital at 14 days and 30 days after joining the study. They will also measure other important outcomes such as survival rates at different time points, whether patients need intensive care, how long they stay in the hospital, their quality of life after six months, and whether they need additional treatments such as breathing support, blood pressure medications, or blood transfusions. The study will also track how long patients need antibiotics and whether their antibiotic treatment needs to be changed or increased.



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