Tigecycline is being developed as an agent that overcomes tetracycline-resistance mechanisms and provides activity against emerging multi-drug resistant pathogens. The purpose of this protocol is to determine the linkage between time related clinical measures of infection response and time to bacterial eradication in patients with intravascular catheter infections caused by Staphylococcus...
Date First Received: January 8, 2007
Last Updated: May 5, 2008
Verified by: CPL Associates, May 2008
Clinical Trial Phase: Phase 4 | Start Date: January 2007
Overall Status: Completed
Estimated Enrollment: 10
Brief Summary
Official Title: “An Open-Label Noncomparative, Multicenter, Clinical Trail Measuring Time Related Clinical Response Factors in Relation to Time to Bacterial Eradication With Tigecycline Treatment in Patients With Catheter Infection”
Condition Keyword(s):
Intervention(s):
Tigecycline is being developed as an agent that overcomes tetracycline-resistance mechanisms and provides activity against emerging multi-drug resistant pathogens. The purpose of this protocol is to determine the linkage between time related clinical measures of infection response and time to bacterial eradication in patients with intravascular catheter infections caused by Staphylococcus epidermidis and other coagulase negative staphylococci.
Study Type: Interventional
Study Design: Treatment, Open Label, Uncontrolled, Single Group Assignment, Pharmacokinetics/Dynamics Study
Study Primary Completion Date: May 2008
Detailed Clinical Trial Description
Tigecycline, a glycylcycline antibiotic and an analog of the tetracycline minocycline, demonstrates a broad spectrum of antibacterial activity by inhibiting multiply resistant gram-positive, gram-negative, anaerobic, and "atypical" bacteria. It is being developed as an agent that overcomes tetracycline-resistance mechanisms and provides activity against emerging multi-drug resistant pathogens. These attributes may provide clinicians with a valuable therapeutic alternative. The purpose of this protocol is to determine the linkage between time related clinical measures of infection response and time to bacterial eradication in patients with intravascular catheter infections caused by Staphylococcus epidermidis and other coagulase negative staphylococci. The study is being conducted in two phases. The first treats patients who have removal of the catheter at the time of treatment, and the second treats patients who have the catheter remaining in situ during tigecycline treatment.
Intervention(s) in this Clinical Trial
- Drug: Tigecycline
- All patients will receive tigecycline infusions approximately every 12 or 24 hours. The usual regimen of tigecycline is (an initial intravenous (IV) dose of 100 mg followed by 50 mg approximately every 12 hours). Patients with severe hepatic dysfunction may, at the investigator's discretion with CPL Associates approval (call enrollment hotline) may be given a total daily dose of 50 mg (one 50 mg dose or 25 mg approximately every 12 hours). Tigecycline infusions will be administered over approximately 30 minutes in 100 mL of normal saline.
Arms, Groups and Cohorts in this Clinical Trial
- No Intervention: 1 Tigecycline
Outcome Measures for this Clinical Trial
Primary Measures
- Time to bacterial eradication
- Time Frame: 7-14 days
- Time Frame: 7-14 days
Secondary Measures
- Safety and Efficacy of Tigecycline in patients with intravascular catheter infections
- Time Frame: 7-14 days
- Time Frame: 7-14 days
Criteria for Participation in this Clinical Trial
Inclusion Criteria:
- Male or female patients, 18-85 years of age and a weight of > 45 kilograms.
- Patients with intravascular catheters and a blood culture that is positive for gram-positive cocci in clusters. Patients will be subsequently excluded from the study analysis if they do not have a culture-positive infection with S. epidermidis or other coagulase negative staphylococci, expected to be susceptible to tigecycline.
- Patients in whom the bacteremia can be cultured daily by the site investigator.
- Patients who have failed other available antibiotic therapies may be enrolled with positive blood cultures and organism susceptibility to tigecycline.
Exclusion Criteria:
- Patients that cannot be cultured daily by the site investigator.
- Intravascular catheter infections known to be caused by bacteria other than a coagulase negative staphylococci, for example, Staphylococcus aureus.
- Any patient who has received more than 24 hrs of vancomycin.
- Any patient who has received any antibiotic active against S. epidermidis other than vancomycin.
- Patients who are moribund with an expected survival of less than 2 weeks.
- Patients who are neutropenic (ANC <500) at the time of bacteremia
- Patients who have been designated as "Do Not Resuscitate", unless it is anticipated within a reasonable degree of medical certainty that they can achieve benefit from tigecycline therapy.
- Known or suspected hypersensitivity to tigecycline, tetracyclines, or other compounds related to this class of antibacterial agents.
- Pregnant women or nursing mothers.
- Female patients of childbearing potential who do not agree to use a medically acceptable method of contraception throughout the duration of the study and for at least 1 month after the last dose of tigecycline.
- Patients with suspected or proven endocarditis or osteomyelitis
- Patients with suspected or proven mycobacterial infections
Gender Eligibility for this Clinical Trial: Both
Minimum Age for this Clinical Trial: 18 Years
Maximum Age for this Clinical Trial: 85 Years
Are Healthy Volunteers Accepted for this Clinical Trial?: No
Clinical Trial Sponsor Information
Lead Sponsor: CPL Associates
Overall Clinical Trial Officials and Contacts
Dennis G Maki, M.D. Principal Investigator University of Wisconsin, Madison
Related Publications
References
Schnappinger D, Hillen W. Tetracyclines: antibiotic action, uptake, and resistance mechanisms. Arch Microbiol. 1996 Jun;165(6):359-69. Review.
Gales AC, Jones RN. Antimicrobial activity and spectrum of the new glycylcycline, GAR-936 tested against 1,203 recent clinical bacterial isolates. Diagn Microbiol Infect Dis. 2000 Jan;36(1):19-36.
Meinl B, Hyatt JM, Forrest A, Chodosh S, Schentag JJ. Pharmacokinetic/pharmacodynamic predictors of time to clinical resolution in patients with acute bacterial exacerbations of chronic bronchitis treated with a fluoroquinolone. Int J Antimicrob Agents. 2000 Nov;16(3):273-80.
Ambrose PG, Anon JB, Owen JS, Van Wart S, McPhee ME, Bhavnani SM, Piedmonte M, Jones RN. Use of pharmacodynamic end points in the evaluation of gatifloxacin for the treatment of acute maxillary sinusitis. Clin Infect Dis. 2004 Jun 1;38(11):1513-20. Epub 2004 May 12. Erratum in: Clin Infect Dis. 2005 Jan 15;40(2):341.
Additional Information
Information obtained from ClinicalTrials.gov on September 05, 2008
Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00419991
Study ID Number: CPLA-6625
ClinicalTrials.gov Identifier: NCT00419991
Health Authority: United States: Institutional Review Board
Clinical Trials Authorship and Review
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