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Daptomycin as an Adjuvant Agent in the Treatment of Enterococcal Native Valve Endocarditis.

Phase 4
Terminated
Conditions
Endocarditis, Bacterial
Interventions
Registration Number
NCT00401960
Lead Sponsor
Weill Medical College of Cornell University
Brief Summary

The aim of this study is to determine the safety and efficacy of daptomycin when used as an adjuvant agent to standard care in the treatment of proven native valve Enterococcal endocarditis. Patients with this disease will be offered the option of receiving daptomycin at a dose of 8 milligrams/kilogram/day in addition to the antibiotics they are already receiving. The hypothesis of this study is that daptomycin added to standard therapy for Enterococcal endocarditis is safe and efficacious.

Patients who receive daptomycin + standard therapy will be compared to patients who receive standard therapy alone with respect to the following outcomes:

1. Safety.

1. The frequency of any Grade 3 or 4 toxicity (DAIDS scale) will be measured.

2. The frequency of muscle toxicity or renal toxicity, as determined by predefined criteria.

2. Efficacy.

1. Clinical efficacy.

* Time to clearance of bacteremia

* Cure at 6 weeks following completion of antibiotic therapy

* Mortality at 6 weeks following completion of antibiotic therapy

2. Microbiologic efficacy.

* Peak and trough serum bactericidal titers

* The minimum bactericidal concentration of Enterococci to daptomycin

We expect to enroll 40 patients over 2 years.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
6
Inclusion Criteria
  • Age 18 or over
  • Definite Enterococcal endocarditis, as defined by modified Duke criteria
  • Able to complete follow-up 3 and 6 weeks following completion of intravenous antibiotic therapy
Exclusion Criteria
  • Pregnancy or breast feeding
  • Creatine phosphokinase levels over two times the upper limit of normal
  • Renal insufficiency or dialysis requirement.
  • Presence of chronic indwelling bloodstream catheters or foreign body devices suspected as primary or secondary sites of enterococcal infection unamenable to removal or replacement
  • Inability to discontinue or abstain from use of a HMG CoA reductase inhibitor during the study period.
  • Hypersensitivity to any of the study medications.
  • Any condition that, in the investigator's opinion, may interfere with protocol compliance including, but not limited to, active substance abuse and/or dementia.
  • Prosthetic valve endocarditis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Daptomycin adjunctive groupDaptomycinPatients with enterococcal endocarditis who elect to receive daptomycin at a dose of 8 milligrams/kilogram/day in addition to the antibiotics they are already receiving
Primary Outcome Measures
NameTimeMethod
Number of Participants With Any Grade 3 or 4 Toxicity (DAIDS Scale)weekly

Number of Participants any Grade 3 or 4 toxicity (DAIDS scale); please see adverse event table for details

Number of Participants With Muscle Toxicity or Renal Toxicity, as Determined by Predefined Criteriaweekly

Number of Participants with creatine kinase elevation \> 3x upper limit of normal or elevations of serum Cr \>= 30% above baseline

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

NewYork-Presbyterian Hospital, Weill Cornell Campus

🇺🇸

New York, New York, United States

NewYork-Presbyterian Hospital, Weill Cornell Campus
🇺🇸New York, New York, United States

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