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Intra-nodal Injection of Gentamicin for the Treatment of Suppurated Cat Scratch Disease's Lymphadenitis

Phase 3
Recruiting
Conditions
Cat-Scratch Disease
Interventions
Drug: placebo
Registration Number
NCT03132116
Lead Sponsor
University Hospital, Toulouse
Brief Summary

To compare effect of intra-nodal injection of gentamicin versus placebo on the outcome at 28 days of suppurated cat scratch disease's (CSD) lymphadenitis treated by oral azithromycin.

Detailed Description

Double blind controlled study versus placebo. Patients with suppurated CSD's lymphadenitis will receive immediately after the pus aspiration (performed for a diagnostic purpose) an intra-nodal injection of gentamicin or of placebo (NaCl 0,9%) and be treated with oral azithromycin for 5 days.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Informed consent

  • Suppurated CSD's adenitis:

    • Suppurated form of adenitis confirmed by echography
    • Serology positive for Immunoglobulin G and/or Immunoglobulin M against B. henselae
Exclusion Criteria
  • Suppurated adenitis non related to CSD
  • Non-suppurated CSD's adenitis
  • Suppurated CSD's adenitis already fistulized
  • Suspected visceral B. henselae infection (neurologic or ophthalmic symptoms, hepato-splenic or valvular involvement confirmed by echography)
  • Immunodepression (except diabetes)
  • Pregnancy
  • Contraindication to pus aspiration from lymphadenitis (history of bleeding or patient taking curative anticoagulation therapy or platelet count < 50.000/mm3)
  • Contraindication to azithromycin (history of QT interval prolongation, history of liver toxicity of hypersensitivity to macrolides or treatment with ergotamine, dihydroergotamine, bepridil, cisapride, pimozide, mizolastine or colchicine) or to aminoglycosides (myasthenia, history of hypersensitivity to aminoglycosides).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placeboplacebointra-nodal injection of placebo
Gentamicingentamicinintra-nodal injection of gentamicin
Primary Outcome Measures
NameTimeMethod
Frequency at day 28 of CSD's adenitis favorable outcomeDay 28

Adenitis favorable outcome characterized as : Reduction of the volume of the adenitis, Without requirement of supplementary needle aspirations after day 7's visit, And without requirement of a surgical excision or incision of the adenitis.

Secondary Outcome Measures
NameTimeMethod
Reduction of the adenitisfrom Day 0 to Day 28

Percentage of volume reduction of the adenitis

Surgical actionDay 28

Number of patients requiring surgical excision or incision of the adenitis

Safety of treatmentDay 7 and day 28

Incidence of Treatment-Emergent Events linked to the study treatment

Fistulization of the adenitisDay 7 and day 28

Number of patients with persisting cutaneous fistulization of the adenitis

Protein C reactiveDay 0 and day 7

Percentage of decrease of serum Protein C reactive

Evaluation of the pain related to the adenitisbetween Day 0, Day 7 and Day 28

Percentage of reduction of the pain related to the adenitis

Antibiotic resistanceDay 28

Genotypic profile of resistance to macrolides and aminoglycosides

Trial Locations

Locations (21)

Amiens-Picardie Hospital

🇫🇷

Amiens, France

Cahors Hospital

🇫🇷

Cahors, France

Nîmes University Hospital

🇫🇷

Nîmes, France

Rennes Hospital

🇫🇷

Rennes, France

Rodez Hospital

🇫🇷

Rodez, France

Limoges University Hospital

🇫🇷

Limoges, France

Bordeaux University Hospital

🇫🇷

Bordeaux, France

Montauban Hospital

🇫🇷

Montauban, France

Pau Hospital

🇫🇷

Pau, France

Perpignan Hospital

🇫🇷

Perpignan, France

Saint-Nazaire Hospital

🇫🇷

Saint-Nazaire, France

Hospices Civils Lyon

🇫🇷

Lyon, France

Vendée Hospital

🇫🇷

La Roche-sur-Yon, France

Montpellier University Hospital

🇫🇷

Montpellier, France

Tarbes Hospital

🇫🇷

Tarbes, France

Albi Hospital

🇫🇷

Albi, France

Angers Hospital

🇫🇷

Angers, France

Auch Hospital

🇫🇷

Auch, France

Castres Hospital

🇫🇷

Castres, France

Saint-Brieuc Hospital

🇫🇷

Saint-Brieuc, France

Microbiology Laboratory

🇫🇷

Toulouse, France

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