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Assessment of the Safety Profile and Efficacy of Ceftolozane/Tazobactam in Nosocomial Pneumonia

Phase 1
Conditions
Ventilated Nosocomial Pneumonia
MedDRA version: 20.1 Level: LLT Classification code 10052596 Term: Nosocomial pneumonia System Organ Class: 100000004862
Therapeutic area: Diseases [C] - Bacterial Infections and Mycoses [C01]
Registration Number
EUCTR2012-002862-11-HR
Lead Sponsor
Cubist Pharmaceuticals LLC, an indirect wholly-owned subsidiary of Merck Sharp & Dohme Corp.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
Not specified
Target Recruitment
726
Inclusion Criteria

1. Provide written informed consent prior to any study-related procedure not part of normal medical care. If the subject is unable to do so, local country laws and institution-specific guidelines and requirements in place for obtaining informed consent should be met. A legally acceptable representative may provide consent, provided this is approved by local country and institution-specific guidelines. If a subject comes to consciousness while still in the study and per the Investigator’s judgment the subject is able to read, assess,understand, and make his/her own decision to participate in the trial, the subject can agree to continue study participation and the subject may be re-consented, if required by local country and institution-specific guidelines;
2. Be males or females aged 18 years or older; If female, subject must not be pregnant or nursing, and is either:
Not of childbearing potential, defined as postmenopausal for at least 1 year or surgically sterile due to bilateral tubal ligation, bilateral oophorectomy, or hysterectomy; or
• Of childbearing potential and meets at least 1 of the following:
? Is practicing an effective method of contraception (eg, oral/parenteral
contraceptives plus barrier method), or
? Has a vasectomized partner, or
? Is currently abstinent from sexual intercourse.
Subjects must be willing to practice the chosen contraceptive method or remain abstinent
during the conduct of the study and for at least 35 days after last dose of study
medication.
Non-vasectomized males are required to practice effective birth control methods
(eg, abstinence, use of condom, or use of other barrier device) during the treatment period
and for at least 35 days after last dose of study medication;
3. Intubated (via endotracheal tube, including tracheostomy patients) and on mechanical
ventilation at the time of randomization:
For ventilated HABP:
• At least 1 of the following signs and/or symptoms must be present within the 24
hours prior to intubation OR within the 48 hours after intubation in a patient who
has been either hospitalized for =48 hours or who has been discharged from a hospital
within the prior 7 days (includes patients institutionalized in skilled nursing or other
long-term care facility):
? A new onset of cough (or worsening of baseline cough)
? Dyspnea, tachypnea, or respiratory rate greater than 30 per minute, particularly if
any or all of these signs or symptoms are progressive in nature
? Hypoxemia defined as an arterial blood gas partial pressure of oxygen less than
60 mmHg while the subject is breathing room air, OR a pulse oximetry oxygen
saturation less than 90% while the subject is breathing room air, OR worsening of
the ratio of the partial pressure of oxygen to the fraction of inspired oxygen
(PaO2/FiO2 ratio)
For VABP:
Receiving mechanical ventilation =48 hours and at least one of the following:
• Acute changes made in the ventilator support system

Exclusion Criteria

1. Any of the following diagnoses or conditions that interfere with the assessment or interpretation of outcome:
•Atypical, viral, or fungal (including Pneumocystis jiroveci), known or suspected community-acquired bacterial pneumonia
•Tracheobronchitis (without documented pneumonia), chemical pneumonitis, or
postobstructive pneumonia
•?Active primary or metastatic lung cancer
•?Pleural effusions (or empyema) requiring therapeutic drainage, lung abscess, or bronchiectasis
•?Cystic fibrosis, acute exacerbation of chronic bronchitis, or active pulmonary
tuberculosis
•?New York Heart Association (NYHA) Stage IV Congestive Heart Failure or Cirrhotic
Liver Disease
•?Full thickness burns (greater than 15% of total body surface area)
•?Severe confounding respiratory condition due to penetrating chest trauma (ie, chest
trauma with paradoxical respiration)
2. Has a documented history of any moderate or severe hypersensitivity (or allergic)
reaction to any ß-lactam antibacterial;
Note: A history of a rash while on a ß-lactam antibiotic does not automatically
exclude a subject
3. Received systemic or inhaled antibiotic therapy effective against Gram-negative
pathogens that cause VNP, for >24 hours in the 72 hours prior to the first dose of study drug.
Drugs with only Gram-positive activity [eg, daptomycin, vancomycin, linezolid] are
allowed.
Exceptions:
•?Persistent/worsening signs and/or symptoms of VNP are still present despite
=48 hours of antibiotic therapy for the treatment of the current VNP, and (a) a
LRT culture obtained while the subject is on the failing antibiotic therapy for
this episode of VNP showed growth of a Gram-negative pathogen and (b) the
isolated pathogen is not known to be resistant to one of the study drugs.
•?Signs and/or symptoms of VNP develop after receiving =48 hours of prior
antibacterial therapy for an indication other than the current VNP.
•?Treatment with a non-absorbed antibiotic used for gut decontamination (eg,
low-dose erythromycin) or to eradicate C. difficile.
4. Baseline Gram stain shows the presence of only Gram-positive bacteria.
Exception: If the subject has a lower respiratory tract culture growing a Gramnegative
pathogen obtained within 72 hours prior to the first dose of study drug, these
results will supersede baseline Gram stain results of only Gram-positive bacteria.
5. Active immunosuppression, including human immunodeficiency virus (HIV) with a
known CD4 count of <200 cells/mm3, active hematological malignancy, recipients of
solid organ or bone marrow transplants, subjects currently on immunosuppressive
therapy including cancer chemotherapy, medications for prevention of transplant
rejection, or chronic administration of corticosteroids (defined as >40 mg of prednisone
per day administered continuously for more tha

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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