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Study Comparing Cubicin With Vancomycin in Treatment of Participants With Complicated Skin and Skin Structure Infections in a Home Infusion Setting

Phase 4
Terminated
Conditions
Complicated Skin or Skin Structure Infection
Interventions
Registration Number
NCT01175707
Lead Sponsor
Cubist Pharmaceuticals LLC, a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA)
Brief Summary

This is a randomized, open-label, multi-center, phase 4 study designed to compare intravenous (IV) daptomycin and IV vancomycin administered in a home infusion setting for the treatment of complicated skin and skin structure infections (cSSSI) due to Gram-positive bacteria in participants who are prescribed vancomycin for 7 to 14 days and who are planning to receive vancomycin in a home-infusion setting.

Detailed Description

This is a randomized, open-label, multi-center, phase 4 study. The overall goals of this study are to compare intravenous (IV) daptomycin and IV vancomycin administered in a home infusion setting for the treatment of cSSSI due to Gram-positive bacteria in participants who are prescribed vancomycin for 7-14 days and who are planning to receive vancomycin in a home infusion setting. Study objectives include evaluation of clinical and resource utilization endpoints and economic analysis from the perspective of the home infusion provider.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Complicated skin or skin structure infection (cSSSI)
  • Intravenous vancomycin home infusion ordered for 7-14 days
Exclusion Criteria
  • Pregnant or lactating female
  • Concurrently receiving other systemic antibiotics with gram positive activity
  • Known or suspected allergy or hypersensitivity to daptomycin or vancomycin
  • Known or suspected vancomycin-resistant enterococci (VRE)
  • Known or suspected osteomyelitis, pneumonia, bacteremia, endocarditis, or urinary tract infection
  • Known or suspected human immunodeficiency virus (HIV), cancer, or autoimmune disease such as lupus
  • Receiving systemic concomitant immunosuppressive agents such as chemotherapy, corticosteroids, tacrolimus, sirolimus, or cyclosporine, during the duration of the study
  • Requirement for non-study gram positive systemic antibiotics
  • Known to be allergic or intolerant to intravenous vancomycin or daptomycin
  • Participants with known or suspected creatinine clearance (CLcr) < 30 milliliters per minute (mL/min)
  • In skilled nursing facility
  • In hospice or admission to hospice is planned

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
VancomycinVancomycinVancomycin monotherapy is administered according to prescribing physician's order with duration of treatment modified, if warranted, according to Investigator site's standard practice, and End of Treatment (EOT) is dependent on this. Dose adjustments of vancomycin will be suggested by the pharmacist and approved by prescribing or following physician
DaptomycinDaptomycin500 milligrams (mg) daptomycin, administered intravenously (IV) for 7 to 10 days accordingly to the package insert or according to institutional practice, if warranted
Primary Outcome Measures
NameTimeMethod
Number of Participants With at Least 1 Unscheduled Nursing Visit During Home Infusion TherapyDay 1 up to Day 14
Number of Participants With at Least One Pharmacist Consultation During Home Infusion TherapyDay 1 up to Day 14
Reasons for Nurse Visits During Home Infusion TherapyDay 1 up to Day 14

The reason for a participant's nurse visit is presented. There may be more than one reason for nurse visits per participant.

Reasons for Pharmacist Consultations During Home Infusion TherapyDay 1 up to Day 14

The reason for a participant's pharmacist consultation is presented. There may be more than one reason for pharmacist consultations per participant.

Percentage of Treatment Goals Met at End of TherapyDay 1 up to Day 14

Treatment goals included: 1. Elimination of infection/achieved desired response. 2. Laboratory values were within normal limits or improved indicating progress toward therapy goal. 3. Pain was controlled. 4. Participant did not have catheter site complications (eg,infection, loss of patency). 5. Participant had no knowledge deficits related to administration, equipment use, side effects and waste disposal. 6. Participant had no side effects, adverse drug reactions and/or drug or food interactions. 7. Signs and symptoms of infection did improve or resolve. 8. Participant was compliant with IV therapy 9. Successfully completed therapy without interruptions, unexpected hospitalizations. 10. Participant continued on an oral antibiotic. 11. Participant continued on an IV antibiotic.

Each participant's percentage was derived from number of treatment goals achieved out of a maximum of 11 goals. Reported percentage below is the average of all participants' percentage of goals met by arm.

Time Spent (Minutes) for Home Infusion TherapyDay 1 up to Day 14

Each participant is counted once per category. Avg=average; Admin=administer.

Number of Nurse Visits or Consultations Per Participant for Home Infusion TherapyDay 1 up to Day 14

Each participant is counted once per category.

Total Antibiotic Therapy Duration (in Days) Per Participant for Home Infusion TherapyDay 1 up to Day 14

The mean duration in home-infusion antibiotic therapy per participant is presented.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With at Least 1 Intervention Related to Complicated Skin or Skin Structure Infection (cSSSI) During Home Infusion TherapyDay 1 up to Day 14

Type of interventions include Intravenous (IV) line replacement, IV line removal, IV line placement (post study therapy), Incision and drainage (wound), Incision and drainage (line), Debridement, Declotting procedure, and Blood draw.

Mean Number of Interventions Per Participant During Home Infusion TherapyDay 1 up to Day 14

Type of interventions include IV line replacement, IV line removal, IV line placement (post study therapy), incision and drainage (wound), incision and drainage (line), debridement, declotting procedure, and blood draw.

Number of Intervention Types During Home Infusion TherapyDay 1 up to Day 14

There may be more than one type of intervention per participant. A participant is counted only once for each category even if they had several instances of a given intervention.

Participants Who Had More Than 1 Laboratory Assessment During Home Infusion TherapyDay 1 up to Day 14

Laboratory assessments include serum creatinine, creatine phosphokinase (CPK), and Vancomycin trough.

Mean Number of Laboratory Assessments Per Participant During Home Infusion TherapyDay 1 up to Day 14

Laboratory assessments include serum creatinine, creatine phosphokinase (CPK), and vancomycin trough.

Number of Laboratory Assessment Types During Home Infusion TherapyDay 1 up to Day 14

There may be more than one type of laboratory assessment per participant. A participant is counted only once for each category. Laboratory assessments include serum creatinine, creatine phosphokinase (CPK), and vancomycin trough

Health Economic Outcomes in United States (US) Dollars for Home Infusion Therapy Per ParticipantDay 1 up to Day 14

Total Heartland costs per participant were derived by summing the costs of drug, pharmacy services/supplies and nursing.

Trial Locations

Locations (2)

Heartland I.V. Care

🇺🇸

Pittsburgh, Pennsylvania, United States

NationsMed Clinical Research, Inc.

🇺🇸

Stafford, Texas, United States

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