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Azithromycin as a Quorum-Sensing Inhibitor for the Prevention of Pseudomonas Aeruginosa Ventilator-Associated Pneumonia

Phase 2
Terminated
Conditions
Pneumonia, Ventilator-Associated
Pseudomonas Infections
Interventions
Drug: placebo
Registration Number
NCT00610623
Lead Sponsor
Anbics Management-Services Ag
Brief Summary

The purpose of this study is to assess the clinical efficacy of azithromycin, used as a quorum-sensing blocker, when compared to placebo for preventing or delaying the occurrence of pneumonia in ventilated patients colonized with Pseudomonas aeruginosa.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
92
Inclusion Criteria
  • Male and non pregnant female aged 18 to 75 years
  • Patients hospitalized in ICU, under mechanically assisted ventilation expected to be mandatory for 3 days or more
  • Reasonable survival chance within next few days with an Apache score 10-25
  • Tracheal aspirate found positive for P. aeruginosa
  • The subject (or a close family member in case of incompetence) understands the procedure, agrees to participate, and is willing to give written informed consent
  • Informed consent must be obtained for all subjects before enrollment in the study, by patient or by a close family member
Exclusion Criteria
  • Poor prognosis as judged by Apache score II score >25
  • Pregnant female
  • Grossly under-or overweight (BMI<18or >29)
  • Ongoing therapy with a macrolide
  • Known allergy to any macrolide
  • Proven P. aeruginosa pneumonia
  • Ongoing anti-pseudomonal therapy with a proven susceptible colonizing strain
  • Anticipated short duration of mechanical ventilation (<3 days)
  • Known drug interaction that could either decrease efficacy or raise safety concerns
  • Severe hepatic failure (type C, score >10 on Child Pugh scale)
  • Sick sinus syndrome or long QT syndrome
  • Recent donation of blood or participation in another clinical trial within 3 months
  • Any situation exposing the patient to higher risk or possibly confounding results

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1azithromycinazithromycin iv 300 mg/day
2placeboPlacebo
Primary Outcome Measures
NameTimeMethod
Occurrence of and time to Pseudomonas aeruginosa pneumoniadaily
Secondary Outcome Measures
NameTimeMethod
occurrence of and time to deathdaily
time to extubationdaily
overall outcomedaily
duration of hospitalization and ICU staydaily
occurrence of infections to other bacterial strainsdaily
cost assessmentdaily
demonstrate using in vitro and in vivo parameters that azithromycin can be used as a quorum-sensing blocker against P. aeruginosadaily
determine whether prolonged treatment with azithromycin may induce resistance to any of 11 anti-pseudomonal antibioticsdaily
determine whether P. aeruginosa can develop resistance to the quorum-sensing effect of azithromycindaily

Trial Locations

Locations (19)

Intensive Care Unit, Clinique Saint-Pierre

🇧🇪

Ottignies, Louvain, Belgium

Surgical Intensive Care Unit, Clinical Center of Serbia

Belgrade, Former Serbia and Montenegro

Surgical Intensive Care Unit, Clinical Center of Serbia, Institut of Neurosurgery

Belgrade, Former Serbia and Montenegro

General Intensive Car Unit, Centre Hospitalier Universitaire de Liège

🇧🇪

Liège, Belgium

Intensive Car Unit, Calmette University Hospital of Lille

🇫🇷

Lille, France

General Intensive Care Unit, Montauban City Hospital

🇫🇷

Montauban, France

Intensive Care Unit, Jean Minjoz University Hospital

🇫🇷

Besancon, France

Medical Intensive Care Unit, Cochin Hospital

🇫🇷

Paris, France

Surgical Intensive Car Unit; University Hospital Bichat

🇫🇷

Paris, France

Medical-surgical intensive car unit, Dupuytren Teaching Hospital

🇫🇷

Limoges, France

Intensive Care Unit, San Dureta University Hospital

🇪🇸

Palma de Mallorca, Spain

Medical Intensive Car Unit, Hospital Bichat

🇫🇷

Paris, France

Intensive Care Unit, Wojewodzki Hospital

🇵🇱

Sosnowiec, Poland

General Intensive Care Unit, Hospital Saint-Joseph

🇫🇷

Paris, France

Intensive Care Unit, Central Hospital

🇵🇱

Warsaw, Poland

Intensive Care Unit, Joan XXIII University Hospital

🇪🇸

Tarragona, Spain

Internal Medicine, Vall d'Hebron Hospital

🇪🇸

Barcelona, Spain

Intensive Care Unit, Hospital del Mar

🇪🇸

Barcelona, Spain

Surgical and Medical Intensive Care Units, University Hospital Lausanne

🇨🇭

Lausanne, Vaud, Switzerland

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