Early oral step-down antibiotic therapy versus continuing intravenous therapy for uncomplicated Gram-negative bacteraemia (the INVEST trial)
Bacterial blood infections are serious illnesses that are usually treated in hospital with antibiotics given directly into a vein through a drip. While drips are effective, keeping a tube in your vein can cause irritation, increase the risk of other infections, and keep you in hospital for longer. The INVEST study aims to see if adults with uncomplicated bacterial blood infections can safely switch to antibiotic tablets once they start improving. Participants will either continue their normal drip treatment or switch early to taking antibiotic pills by mouth. The trial will follow patients for up to 90 days to monitor their recovery, check for side effects, and see how quickly they can safely go home. The results could help doctors provide simpler, more comfortable treatment for future patients across the NHS.
At a glance
What is this study about?
When bacteria enter the bloodstream, it causes an illness doctors call a blood infection (or bacteraemia). Standard care usually involves staying in hospital to receive antibiotics through a small plastic tube in your vein, known as an intravenous (IV) drip. Drips deliver medicine quickly, but having a line in your vein comes with downsides, including discomfort, blood clots, and line infections. It can also delay your return home.
Many modern antibiotic tablets are absorbed very well by the body. Doctors want to find out if switching patients to tablets as soon as their condition stabilises is just as safe and effective as finishing the whole course through a drip. Switching to tablets could help patients get their drips removed sooner, reduce hospital-acquired complications, and allow people to recover in the comfort of their own homes.
The INVEST study compares these two treatment methods. Half of the patients taking part will continue receiving their antibiotics through a drip as usual, while the other half will switch to antibiotic tablets. Researchers will follow both groups closely to see if there is any difference in recovery, side effects, or hospital stay lengths.
By taking part, patients help the NHS understand whether a simple switch to tablets can become the new standard of care, making recovery easier and safer for everyone.
Key takeaways
- The INVEST study compares antibiotic tablets against continuing antibiotic drips for blood infections.
- The goal is to see if tablets are just as safe and effective while helping patients avoid drip-related problems.
- All medicines in this trial are already approved and widely used in the NHS.
- Participants are followed for 90 days to check recovery, hospital stays, and overall well-being.
- Taking part is completely voluntary and will not affect your standard NHS care.
Who may be eligible?
This trial is for adults aged 18 and over who have been admitted to hospital with an uncomplicated bacterial blood infection. An 'uncomplicated' infection means the source of the bacteria is being managed and the infection has not spread to hard-to-treat areas, such as artificial joints or heart valves.
To take part, your medical team must feel that you are starting to improve and that your stomach is working well enough to absorb medicine taken by mouth. You must also be able to safely swallow tablets.
You might not be eligible if you have a very complex medical background, an uncontrolled infection, or allergies to the study antibiotics. Your hospital doctors will check your blood tests and overall health to ensure that taking part is completely safe for you.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am aged 18 or older.
- I am currently in hospital with a bacterial blood infection.
- My infection is considered uncomplicated and under control.
- I am able to swallow and keep down tablets.
- I do not have known severe allergies to the study antibiotics.
What does participation involve?
If you decide to take part, a computer will randomly place you into one of two groups. One group will continue standard antibiotic treatment through a drip, while the other group will switch early to antibiotic tablets. Both groups receive well-established, approved antibiotics.
While you are in hospital, your care team will monitor your symptoms, temperature, and blood tests as normal. Once you are well enough to leave hospital, the study team will stay in touch to check on your recovery. Follow-up usually lasts for 90 days from the start of the study. This mainly involves brief chats over the phone or during routine clinic visits to ask how you are feeling, check if you have needed any other medicines, and make sure your infection has not returned.
Potential risks and benefits
Locations (3)
- —UnverifiedSpain
- —UnverifiedItaly
- —UnverifiedGreece
Common questions
How is it decided whether I get tablets or a drip?
A computer programme chooses your group at random, like flipping a coin. This ensures the study gives fair, unbiased results.
Are the antibiotic tablets new or experimental?
No. The antibiotics used in this study are already approved, standard medicines that doctors have used safely for many years.
What happens if the tablets do not work for me?
Your hospital team will monitor you closely. If your symptoms worsen or you cannot keep tablets down, you will be switched back to a drip immediately.
Will taking part help me go home sooner?
Patients who switch to tablets can often have their drips removed earlier, which may allow them to finish their recovery at home sooner if they are medically well.
Can I leave the study if I change my mind?
Yes. You can leave the study at any time without giving a reason, and your regular medical care will carry on as normal.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
Discussion
Community discussion
Powered by our forum at community.patient.info. Please be respectful — this is not medical advice.