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Does Cefoxitin or Piperacillin-Tazobactam Prevent Postoperative Surgical Site Infections After Pancreatoduodenectomy?

Phase 3
Completed
Conditions
Pancreas Cancer
Pancreatic Diseases
Pancreatic Cancer
Interventions
Registration Number
NCT03269994
Lead Sponsor
Memorial Sloan Kettering Cancer Center
Brief Summary

The purpose of this study is to figure out which commonly used antibiotic, cefoxitin or piperacillin-tazobactam, is better at decreasing the rate of surgical site infections after pancreatoduodenectomy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
958
Inclusion Criteria
  • Age >/= 18 years
  • Patients undergoing elective pancreatoduodenectomy (PD) for any diagnosis/indication
Exclusion Criteria
  • Patients undergoing a minimally invasive PD, such as laparoscopic or robotic PD
  • Patients with known and documented allergies to any of the penicillins, cephalosporins, or ฮฒ-lactamase inhibitors
  • Patients who are otherwise ineligible to receive the antibiotics in this study
  • Patients highly unlikely to undergo PD according to the surgeon's judgment, such as conditions amenable to pancreas enucleation, ampullectomy, etc.
  • Patients with long-term glucocorticosteroid use. The following uses of corticosteroids are permitted: single doses, topical applications (e.g., for rash), inhaled sprays (e.g., for obstructive airways diseases), eye drops or local injections (e.g., intra-articular)
  • Patients unable to provide informed consent
  • Creatinine clearance (CrCl) </= 40 mL/min
  • Patients receiving hemodialysis or peritoneal dialysis
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test
  • Patients with a known bacterial infection present at the time of surgery or who received antimicrobial therapy within 7 days prior to surgery

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CefoxitinCefoxitin-
Piperacillin-tazobactamPiperacillin-tazobactam-
Primary Outcome Measures
NameTimeMethod
Compare the effectiveness of cefoxitin with piperacillin-tazobactam as surgical antibiotic prophylaxis in decreasing the overall rate of postoperative surgical site infections in participants undergoing pancreatoduodenectomy30 days

To compare the effectiveness of cefoxitin, a second generation cephalosporin (Cohort 1), with piperacillin-tazobactam, a broad-spectrum penicillin (Cohort 2), as surgical antibiotic prophylaxis in decreasing the overall rate of postoperative SSIs in patients undergoing PD. The primary endpoint, overall SSI rate, is defined as superficial incisional SSI, deep incisional SSI, or organ/space SSI within the first 30 days after the operation, as defined according to the ACS NSQIP data collection operations manual.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (32)

Emory University School of Medicine

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Atlanta, Georgia, United States

Massachusetts General Hospital

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Boston, Massachusetts, United States

Hackensack Meridian Health / Hackensack University Medical Center Cancer Center

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Hackensack, New Jersey, United States

Northwestern Medicine (Data Collection)

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Chicago, Illinois, United States

University of Washington School of Medicine

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Saint Louis, Missouri, United States

Indiana University

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Indianapolis, Indiana, United States

University of Iowa

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Iowa City, Iowa, United States

Memorial Sloan Kettering Cancer Center

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New York, New York, United States

Memorial Sloan Kettering Commack (Consent only)

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Commack, New York, United States

NorthShore University Health System

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Evanston, Illinois, United States

Brody School of Medicine at East Carolina University

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Greenville, North Carolina, United States

Memoral Sloan Kettering Westchester (Consent only)

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Harrison, New York, United States

Ohio State University

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Columbus, Ohio, United States

Duke University

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Durham, North Carolina, United States

University of Wisconsin

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Madison, Wisconsin, United States

University of Utah

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Salt Lake City, Utah, United States

Providence Health & Services (Portland Med Ctr)

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Portland, Oregon, United States

University of Nebraska Medical Center

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Omaha, Nebraska, United States

Thomas Jefferson University Hospital

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Philadelphia, Pennsylvania, United States

UC Davis Comprehensive Cancer Center

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Sacramento, California, United States

Memorial Sloan Kettering Basking Ridge (Consent only)

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Basking Ridge, New Jersey, United States

Mount Sinai Hospital

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New York, New York, United States

Mount Sinai West

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New York, New York, United States

Pennsylvania State Hershey

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Hershey, Pennsylvania, United States

Baptist Memorial Healthcare

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Memphis, Tennessee, United States

Baylor Scott & White Health

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Dallas, Texas, United States

Gundersen Lutheran Medical Foundation

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La Crosse, Wisconsin, United States

Intermountain Healthcare

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Murray, Utah, United States

Ottawa Hospital

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Ottawa, Ontario, Canada

Hamilton Health Sciences Center (Juravinski Hospital)

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Hamilton, Ontario, Canada

Sunnybrook Health Sciences Centre

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Toronto, Ontario, Canada

Montefiore Health Systems (Montefiore Medical Center)

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Bronx, New York, United States

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