MedPath

Pentoxifylline and Late Onset Sepsis in Preterm Infants

Phase 3
Completed
Conditions
Neonatal Late Onset Sepsis
Interventions
Registration Number
NCT02163174
Lead Sponsor
Abd Elazeez Attala Shabaan
Brief Summary

* Hypothesis: The investigators hypothesized that Pentoxifylline has potent anti-inflammatory effect which can augment the antimicrobial effect of antibiotics in treatment of Late onset sepsis (LOS) in preterm infants thus decreasing neonatal mortality and morbidity.

* The purpose of this study: to assess the efficacy and safety of Pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity of preterm infants with LOS.

Detailed Description

* Role of pentoxifylline, a phosphodiesterase inhibitor, in reducing mortality associated with neonatal sepsis is not well studied.

* Hypothesis: we hypothesized that Pentoxifylline has potent anti-inflammatory effect which can augment the antimicrobial effect of antibiotics in treatment of Late onset sepsis (LOS) in preterm infants thus decreasing neonatal mortality and morbidity.

* Purpose of the study: to assess the efficacy and safety of Pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity of preterm infants with LOS.

* Design: A prospective, randomized, double-blind clinical trial.

* Setting: Neonatal Intensive Care Unit, Mansoura University Children's Hospital.

* Patients: 120 preterm infants with suspected or confirmed LOS.

* Intervention: Enrolled infants were randomly assigned to receive intravenous Pentoxifylline (5 mg/kg/hr for 6 hours on 6 successive days) or placebo in addition to antibiotics.

* Primary outcome: Death before hospital discharge.

* Secondary outcomes: Length of hospital stay, duration of respiratory support, duration of antibiotics use, chronic lung disease, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, Serum levels of Tumor necrosis factor, C-Reactive protein levels, and adverse effects of Pentoxifylline.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Appropriate for gestational age preterm infants with suspected or confirmed late onset sepsis
Exclusion Criteria
  • Preterm infants with major congenital malformations
  • Preterm infants with chromosomal anomalies
  • Preterm infants with inborn-errors of metabolism
  • Preterm infants with congenital infection

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Pentoxyfilline armPentoxifylline (PTX)Pentoxifylline 5 mg/kg/hr for 6 hours on 6 successive days in addition to antibiotics.
Placebo armPlaceboIntravenous saline as a Placebo 5 mg/kg/hr for 6 hours on 6 successive days in addition to antibiotics.
Primary Outcome Measures
NameTimeMethod
Neonatal mortalityExpected 10 weeks postnatal age

Mortality before discharge from neonatal intensive care unit

Secondary Outcome Measures
NameTimeMethod
Length of hospital stayExpected average of 8 weeks post natal age

Duration of hospital admission (days)

Duration of respiratory supportExpected 4 to 6 weeks postnatal age

Duration of respiratory support including oxygen, Continuous Positive Airway Pressure, mechanical ventilation(days)

Duration of antibiotics useExpected 3 to 5 weeks postnatal age

Duration of treatment of sepsis including meningitis

Chronic lung diseaseBy 36 weeks corrected gestational age

Need for oxygen by 36 weeks corrected gestational age

Necrotising enterocolitisExpected 6 weeks

Bell clinical and radiological criteria

Intraventricular haemorrhageExpected 2 weeks

By cranial ultrasound grading

Periventricular leukomalaciaExpected 8 weeks

By cranial ultrasound

Serum levels of Tumor necrosis factor-α, C-Reactive protein6 days after intervention
Retinopathy of prematurityExpected 8 weeks

Ophthalmologist using Ret-Cam

Adverse effects of PentoxifyllineUp to 10 days after intervention

Adverse effects of Pentoxifylline such as feeding intolerance, thrombocytopenia and cholestasis.

Trial Locations

Locations (1)

Mansoura University Children Hospital

🇪🇬

Mansoura, Eldakahlia, Egypt

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