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A Study to Evaluate Pre-emptive Treatment for Invasive Candidiasis in High Risk Surgical Subjects

Phase 2
Completed
Conditions
Mycoses
Interventions
Drug: placebo
Registration Number
NCT01122368
Lead Sponsor
Astellas Pharma Inc
Brief Summary

Subjects with intra-abdominal infection requiring surgery and Intensive Care Unit stay will be treated early with micafungin or placebo to determine the incidence and time to confirmation of fungal infection.

Detailed Description

Subjects will be assessed at the following visits:

* Baseline (after surgery, prior to randomization)

* End of Treatment (EOT) visit (EOT is defined as: requires alternative antifungal, sufficient improvement of surgical condition, confirmed fungal infection or death)

* End of Study visit (28 days after the EOT visit)

* Long-term Follow up visit (90 days after the EOT visit)

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
252
Inclusion Criteria
  • Intra-abdominal infection requiring surgery and Intensive Care Unit stay
  • If Community Acquired Intra-Abdominal Infection, at least 72 hours (but not more than 120 hours) of Intensive Care Unit stay, counted from the end of surgery, and a further expected duration of Intensive Care Unit stay of ≥ 48 hours
  • If Nosocomial Intra-Abdominal Infection, duration of Intensive Care Unit stay ≤ 48 hours, counted from the end of surgery, and a further expected duration of Intensive Care Unit stay of ≥ 48 hours
  • Female subject of childbearing potential must have a negative urine or serum pregnancy test prior to randomization and must agree to maintain highly effective birth control during the study
Exclusion Criteria
  • Acute pancreatitis
  • Neutropenia (ANC <1,000/mm3) at the time of randomization
  • Infected intra-peritoneal dialysis
  • Patients undergoing solid organ transplantation
  • Documented invasive candidiasis at the time of randomization
  • Expected survival < 48 hours
  • Any systemically active anti-fungal within 14 days prior to administration of the study drug
  • Allergy, hypersensitivity, or any serious reaction to an echinocandin anti-fungal or any of the study drug excipients
  • Currently receiving and/or has taken an investigational drug within 28 days prior to randomization
  • Pregnant woman or breast-feeding mother
  • 'Do Not Resuscitate' order

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2 PlaceboplaceboIV
1 MicafunginmicafunginIV
Primary Outcome Measures
NameTimeMethod
The incidence of Invasive Fungal InfectionDuring treatment
Time from baseline to the first confirmation of Invasive Fungal InfectionBaseline to End of Treatment visit
Secondary Outcome Measures
NameTimeMethod
All-cause mortalityAt the End of Study and Long-Term Follow Up visit
Organ failure-free daysFrom Day 1 until 28 days after end of study drug treatment
Assessment of the safety of micafungin when used as a pre-emptive treatmentAt the End of Study visit
Fungal-free survivalFrom Day 1 until 28 days after end of study drug treatment
Intensive Care Unit (ICU)-free daysFrom Day 1 until 28 days after end of study drug treatment
Health-related quality of lifeAt the End of Study visit
The level of organ dysfunctionAt the EOT visit
The incidence during the treatment period and the time to confirmation of the composite endpoint (defined as confirmation of Invasive Fungal Infection and/or administration of alternative anti-fungal therapy)At the EOT visit
The emergence or persistence of fungal colonizationAt the EOT visit
To assess the requirement for additional abdominal surgery/intervention.At the End of Study visit
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