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Efficacy of Polymyxin B Against Infections Caused by Extensively Drug-resistant (XDR) Gram-Negative Bacteria

Phase 4
Conditions
Hospital Infection
Interventions
Registration Number
NCT02328183
Lead Sponsor
Mahidol University
Brief Summary

The objective of the study is to evaluate the efficacy of Polymyxin B for treatment Gram negative bacterial infection. The hypothesis of study is Polymyxin B would be the new antibacterial agents for Thai Gram negative infected patients in case of desirable outcomes and minimal side effects.

Detailed Description

* Investigator is notified by doctors who take care of gram negative infected patients.

* Investigator inform patient or their relatives about all topics in project, eligible criteria, method, material and monitoring treatment.

* After patient or their relatives are appreciated to join this project, investigator collect data in case record form;electronics form, then implement the drug.

* Duration of treatment is determined by site and severity of infection, approximately 7-14 days.

* Sample size calculation, by prevalence formula, we estimate the mortality rate about 50 %, deviation 10 %,and 2-sided 95% Confidence interval, therefore,97 persons

* We estimate gather data about 100 persons.

* Statistical descriptive analysis for descriptive data.

* During the study is performing, all unexpected adverse event definitely report to Siriraj institutional Review Board immediately, in addition to subjects or their relatives.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Age 18-75 year-old
  • The infection caused by carbapenem-resistant (CR) Enterobacteriaceae, CR P.aeruginosa or CR A. baumannii which susceptible to colistin
  • The duration of treatment approximately between 7-14 days
  • Kidney function, according to Kidney Disease Improving Global Outcomes (KDIGO) classification, should less than stage 4 and no replacement therapy in all modality.
  • The patients are anticipated to live more than 48 hrs after participation.
  • In case of Colistin administration beforehand, it should not exceed 24 hrs.
  • All of participants should be willing to join this project.
Exclusion Criteria
  • Pregnancy and lactation
  • End stage renal disease who take renal replacement therapy
  • Any type of Neuromuscular disease
  • Body mass index exceed 30
  • Infection that require treatment more than 14 days

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Polymyxin BPolymyxin BPolymyxin B 1.5-2.5 mg/kg/day intravenous q 12 hrs duration 7-14 days
Primary Outcome Measures
NameTimeMethod
mortality rateparticipants will be followed for the duration of hospital stay, an expected average of 4 weeks

mortality rate of gram negative bacteria infected patients receiving Polymyxin B at day 28 after enrollment

Secondary Outcome Measures
NameTimeMethod
microbiological clearanceparticipants will be followed for the duration of hospital stay, an expected average of 4 weeks

we perform culture and staining to assess bacterial clearance after apply the study drug every 3 days until culture is negative

Peak Plasma Concentration (Cmax) of polymyxin Bparticipants will be followed for the duration of hospital stay, an expected average of 4 weeks

we do the blood test for drug level at before the third date dose then 1,2,4 hours after administration of the polymixin B and before the fourth dose.

adverse drug reactionsparticipants will be followed for the duration of hospital stay, an expected average of 4 weeks

we assess adverse drug reactions in 2 aspects; nephrotoxicity and neurotoxicity

Trial Locations

Locations (1)

Siriraj hospital

🇹🇭

Bangkok, Thailand

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