Prediction and Prevention of Bloodstream Infections After Kidney Transplantation - the PREDICT Study
After receiving a kidney transplant, patients take medications to stop their body rejecting the new organ. While vital, these medicines lower the immune system and make infections—especially in the urine and bloodstream—much more common and serious. The PREDICT study is investigating whether taking an antibiotic called pivmecillinam for six months after surgery can stop these infections before they start. Researchers are comparing pivmecillinam with a dummy pill (known as a placebo). Throughout the study, doctors will closely track how well your new kidney is working, whether you pick up any infections, and if you experience any side effects. They will also look at how the treatment affects your gut health and overall quality of life. The aim is to find a safe, routine way to protect transplant patients and help them recover with confidence.
At a glance
What is this study about?
Having a kidney transplant can be life-changing, but the first few months after surgery require careful medical care. To prevent your body from rejecting the new kidney, you need to take medicines that dampen your immune system. Unfortunately, a weakened immune system makes it much easier for bacteria—particularly those that normally live harmlessly in the gut—to cause urinary tract infections (UTIs) or enter the bloodstream.
Bloodstream infections can be very dangerous for transplant recipients. They can lead to hospital stays, damage the new kidney, or cause severe illness. The PREDICT clinical trial is testing whether taking a regular preventative antibiotic called pivmecillinam can shield patients from these harmful bacteria during the critical first six months after a transplant.
In this trial, half of the participants will receive pivmecillinam, while the other half will receive a dummy tablet called a placebo. By comparing the two groups, researchers can see clearly whether the antibiotic reduces infections, protects kidney function, and helps patients stay out of hospital.
The researchers will also examine whether preventative antibiotics alter natural gut bacteria or lead to antibiotic resistance. The overall goal is to give doctors clear, reliable evidence on how best to keep transplant recipients safe, healthy, and thriving.
Key takeaways
- Tests whether the antibiotic pivmecillinam helps prevent urine and blood infections after a kidney transplant.
- Participants take either the antibiotic or a dummy tablet (placebo) for six months.
- Trial appointments usually fit into your routine post-transplant check-ups.
- Researchers will monitor your kidney health, side effects, and overall quality of life.
- Taking part is completely voluntary and will not affect your standard NHS care.
Who may be eligible?
This study is designed for adults aged 18 and older who are having, or have recently had, a kidney transplant. Both men and women are welcome to take part.
Because pivmecillinam is a penicillin-type antibiotic, people with known penicillin allergies cannot take part. You must also be able to swallow tablets and be willing to attend regular follow-up checks alongside your normal transplant care.
Your transplant team will review your full medical history, your kidney health, and any other medications you take to make sure joining the trial is safe and appropriate 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 have recently received or am about to receive a kidney transplant.
- I do not have an allergy to penicillin or related antibiotics.
- I am able to swallow tablets every day.
- I am happy to complete study check-ups over a six-month period.
What does participation involve?
If you decide to take part, you will be randomly assigned by a computer to take either pivmecillinam or a matching dummy tablet (placebo) every day for six months after your transplant. Neither you nor your doctor will know which one you are receiving, which ensures the results are completely fair.
Most trial checks will happen during your normal post-transplant hospital appointments. At these visits, the medical team will test your blood and urine to monitor your kidney function and check for any signs of bacteria. At the six-month mark, you will be asked to fill in a questionnaire about your daily health and quality of life. Your participation will last for approximately six months after your operation.
Potential risks and benefits
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Common questions
What is pivmecillinam?
Pivmecillinam is an established antibiotic commonly prescribed in the UK to treat bladder and urinary tract infections. In this study, doctors want to see if using it as a preventative measure works well for transplant patients.
What is a placebo and why is it used?
A placebo is a dummy tablet that looks and tastes identical to the real medicine but contains no active ingredients. It helps researchers prove whether any health improvements are truly caused by the antibiotic.
Will this trial interfere with my anti-rejection medicines?
The study team will carefully check all your routine transplant medications to make sure there are no harmful interactions before you begin taking the study tablets.
What happens if I get an infection during the trial?
You will be treated promptly with standard NHS care. Your doctors can prescribe whatever antibiotics you need to clear the infection safely.
Can I leave the study if I change my mind?
Yes. You are free to stop taking part at any point, and you do not have to give a reason. Your standard medical care will continue as normal.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
Discussion
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