Stroke Adverse Outcome is Associated With Nosocomial Infections: PCTus- Guided Antibacterial Therapy in Severe Ischemic Stroke Patients (STRAWINSKI)

Stroke Adverse Outcome is Associated With Nosocomial Infections: PCTus- Guided Antibacterial Therapy in Severe Ischemic Stroke Patients

Development of stroke associated pneumonia (SAP) has a detrimental effect on stroke outcome. Biomarker-guided antibiotic treatment of patients at high risk for pneumonia may help to improve stroke outcome. Therefore, the investigators will evaluate whether intensified infection monitoring via Procalcitonin guiding an early standardized antibiotic treatment improves functional outcome after stroke compared with standard therapy based on current guidelines.

Inclusion Criteria:

• age ≥18 years
• stroke onset within the last 40 hours before randomisation
• clinical diagnosis of a severe (NIHSS > 9), non-lacunar stroke in the middle cerebral artery territory
• consent given by the patient or by his/her legitimate representative where patients are incapable of giving consent themselves

Exclusion Criteria:

• CT evidence of an intracerebral haemorrhage or a lacunar infarct as the probable cause of the current illness
• Antibiotic use within the last 10 days
• Suspected life expectancy of < 3 months
• Participation in other interventional trials (on pharmaceuticals or medical devices)
• Pregnancy, lactation
• Pre-stroke mRS score ≥ 4