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Clinical Trials/NCT02380352
NCT02380352
Completed
Phase 4

Short-course Antimicrobial Therapy for Paediatric Respiratory Infections

Hamilton Health Sciences Corporation2 sites in 1 country281 target enrollmentSeptember 2016

Overview

Phase
Phase 4
Intervention
Amoxicillin
Conditions
Community-acquired Pneumonia
Sponsor
Hamilton Health Sciences Corporation
Enrollment
281
Locations
2
Primary Endpoint
Early clinical cure (Resolution of tachypnoea, increased work of breathing, and fever)
Status
Completed
Last Updated
4 years ago

Overview

Brief Summary

Randomized controlled double-blind non-inferiority clinical trial to determine whether five days of high-dose amoxicillin leads to comparable rates of early clinical cure compared with 10 days of high-dose amoxicillin for previously healthy children with mild community-acquired pneumonia.

Registry
clinicaltrials.gov
Start Date
September 2016
End Date
April 2020
Last Updated
4 years ago
Study Type
Interventional
Study Design
Parallel
Sex
All

Investigators

Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Children aged 6 months to 10 years presenting with CAP will be eligible. CAP will be defined if all of the four following numeric criteria are met:
  • fever (\>37.5 C axillary, \> 37.7 C oral, or \>38 C rectal) recorded in the ED or at home in the 48h prior to presentation;
  • any one of:
  • tachypnoea on exam (\>60 bpm for age \<1 y, \>50 bpm for 1-2 y of age, \>40 bpm for 2-4 y of age, and \>30 bpm for \>4 y of age);
  • cough on exam or by history;
  • increased work of breathing on exam; or
  • auscultatory findings (focal crackles, bronchial breathing, etc.) consistent with pneumonia;
  • infiltrates on chest radiograph consistent with bacterial CAP as judged by the ED physician; and
  • the attending ED physician diagnoses the child with primary CAP. (Children treated with systemic steroids in the ED will be presumed to have primary asthma exacerbation with possible infection and therefore will not meet inclusion criteria.)
  • Participants must be well enough to be treated as outpatients (discharged home by the ED physician, adequate volume status, able to tolerate oral medication, oxygen saturation \> 90%, no evidence of impending respiratory failure), and have no evidence of empyaema or necrotizing pneumonia on chest radiograph.

Exclusion Criteria

  • Children will be excluded if they have any of the following: cystic fibrosis, anatomic lung disease, bronchiectasis, congenital heart disease, history of repeated aspiration or velopharyngeal incompetence, malignancy, conditions requiring treatment with immune suppressants, primary immunodeficiency, advanced HIV infection, prolonged admissions (\>48 h) to hospital within the past 2 months, pneumonia previously diagnosed within the past month, lung abscess diagnosed within the past six months, receipt of \> 24 hours of beta-lactam antibiotic therapy already received at presentation to the ED, receipt of at least a 5 day course of amoxicillin \< 72h prior to presenting to the ED, receipt of an intravenous cephalosporin or azithromycin in the ED, or suspected allergy to penicillin. Children will not be eligible to participate more than once.

Arms & Interventions

Short-course

5 days amoxicillin 90 mg/kg/day divided TID followed by 5 days placebo TID

Intervention: Amoxicillin

Short-course

5 days amoxicillin 90 mg/kg/day divided TID followed by 5 days placebo TID

Intervention: Placebo

Standard

5 days amoxicillin 90 mg/kg/day divided TID followed by alternate formulation 5 days amoxicillin 90 mg/kg/day divided TID

Intervention: Amoxicillin

Outcomes

Primary Outcomes

Early clinical cure (Resolution of tachypnoea, increased work of breathing, and fever)

Time Frame: at 14-21 days post-enrolment

Resolution of tachypnoea, increased work of breathing, and fever

Secondary Outcomes

  • Days of missed/disrupted work for caregiver(s)(up to 14 days post-enrolment)
  • Days of adverse reactions(up to 14 days post-enrolment)
  • Days of missed school(up to 14 days post-enrolment)
  • Adherence to study medications(up to 10 days post-enrolment)

Study Sites (2)

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