Safety and Efficacy of SA4Ag Vaccine in Adults Having Elective Open Posterior Spinal Fusion Procedures With Multilevel Instrumentation
- Conditions
- Staphylococcal Vaccine
- Interventions
- Biological: Staphylococcus aureus 4-Antigen (SA4Ag) VaccineOther: Placebo
- Registration Number
- NCT02388165
- Lead Sponsor
- Pfizer
- Brief Summary
The purposes of the clinical trial are to determine whether the SA4Ag vaccine can prevent postoperative Staphylococcus aureus infections in patients who are undergoing elective spinal fusion surgery, and to evaluate the safety of SA4Ag in patients who are undergoing elective spinal surgery.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 3450
- Subject must be scheduled to undergo an elective open posterior spinal fusion procedures with multilevel instrumentation, 10 to 60 days after study vaccination.
- Subject must be available for the entire duration of the study, and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures including completion of the electronic diary for 10 days after study vaccination.
- Aged 18 to <86 years old
- Planned spinal fusion procedure requiring separate operations performed on separate days (ie, staged procedure).
- Surgical indication of malignancy, infection or acute or emergency trauma.
- History of major surgery within 3 months prior to enrollment, or anticipated major surgery other than the Index Surgical Procedure between study enrollment and completion of study participation.
- History of any spinal surgery performed within 6 months prior to study enrollment.
- History of any previous spinal surgery resulting in postoperative BSI or SSI.
- Congenital or acquired immunodeficiency disorder, rheumatologic disorder or other illness requiring chronic treatment with known immunosuppressant medications, including monoclonal antibodies within a year of enrollment or the use of systemic corticosteroids for > 14 days within 30 days prior to enrollment.
- History of leukemia, lymphoma, underlying bone marrow disorder or history of bone marrow transplant.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description SA4Ag Staphylococcus aureus 4-Antigen (SA4Ag) Vaccine Staphylococcus aureus 4-antigen Vaccine Placebo Placebo Diluent (sterile water) for Placebo
- Primary Outcome Measures
Name Time Method Number of Participants With Serious Adverse Events (SAEs) From Vaccination Until Last Postoperative Evaluation on Day 180 From vaccination up to Day 180 after surgery (190-240 days after vaccination) An AE was any untoward medical occurrence in a participant who received study vaccine without regard to possibility of causal relationship. A serious adverse event (SAE) was an AE resulting in any of the following outcomes or deemed significant for any other reason: death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), persistent or significant disability/incapacity, congenital anomaly.
Percentage of Participants With Systemic Reactions Within 10 Days After Vaccination Within 10 days after Vaccination Systemic reactions included fever, fatigue, headache, diarrhea, vomiting, muscle pain and joint pain, were recorded using an e-diary. Fever was graded as 38.0 to 38.4 degree Celsius (C), 38.5 to 38.9 degree C, 39.0 to 40.0 degree C and greater than (\>) 40.0 degree C. Vomiting was graded as mild (1-2 times in 24 hours), moderate (\>2 times in 24 hours) and severe (required intravenous hydration). Diarrhea was graded as mild (2-3 loose stools in 24 hours), moderate (4-5 loose stools in 24 hours) and severe (\>=6 loose stools in 24 hours). Headache, fatigue, muscle pain and joint pain were graded as mild (no interference with activity), moderate (some interference with activity) and severe (prevented daily routine activity). Participants may be represented in more than 1 row. Here "any" for fever, fatigue, headache, vomiting, diarrhea, muscle pain, joint pain represents any grade of these systemic reactions among mild, moderate or severe.
Number of Participants With Adverse Events (AEs) From Vaccination Until The Day of Surgery (Day 1) From vaccination up to Day of surgery (Day 1) (10-60 days after vaccination) An adverse event (AE) was any untoward medical occurrence in a participant who received study vaccine without regard to possibility of causal relationship. AEs including serious as well non-serious AEs.
Percentage of Participants With Local Reactions Within 10 Days After Vaccination Within 10 days after Vaccination Local reactions were recorded using an electronic diary (e-diary). Local reactions included redness, swelling and pain at the injection site. Redness and swelling were categorized as mild (2.5 to 5.0 centimeters \[cm\]), moderate (5.5 to 10.0 cm) and, severe (greater than or equal to \[\>=\] 10.5 cm). Pain at the injection site was defined as mild (did not interfere with activity), moderate (interfered with activity), and severe (prevented daily activity). Participants may be represented in more than 1 row. Here, "Any" for redness, swelling, pain at the injection site represents any grade of these local reactions among mild, moderate or severe.
Number of Participants With Adverse Events (AEs) From Vaccination Until First Postoperative Evaluation on Day 42 From vaccination until Day 42 after surgery (52-102 days after vaccination) An AE was any untoward medical occurrence in a participant who received study vaccine without regard to possibility of causal relationship. AEs including serious as well non-serious AEs.
Number of Participants With Serious Adverse Events (SAEs) From Vaccination Until Day of Surgery (Day 1) From vaccination up to Day of surgery (Day 1) (10-60 days after vaccination) An AE was any untoward medical occurrence in a participant who received study vaccine without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), persistent or significant disability/incapacity, congenital anomaly.
Number of Participants With Serious Adverse Events (SAEs) From The Day of Surgery (Day 1) Until Last Postoperative Evaluation on Day 180 Day of surgery (Day 1) up to Day 180 after surgery An AE was any untoward medical occurrence in a participant who received study vaccine without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), persistent or significant disability/incapacity, congenital anomaly.
Number of Participants With Postoperative Staphylococcus (S.) Aureus Bloodstream Infection (BSI) And/or Surgical-site Infection (SSI-Including Deep Incisional or Organ/Space) Occurred Within 90 Days After Spinal Surgery Day of surgery (Day 1) up to Day 90 BSI: clinical infection involved a recognized pathogen (S. aureus) cultured from 1 or more blood cultures or a commensal organism cultured from 2 or more blood cultures whether primary or secondary to infection at another site. SSI: infection at a surgical incision. Types of SSI in this outcome measure: Deep incisional SSI: infection involved deep soft tissues of incision (example \[e.g.\] fascial and muscle layers), Organ/space SSI: infection involved any part of body excluding skin incision, fascia or muscle layers, that was opened or manipulated during operative procedure. Overall number of participants with postoperative BSI and/or SSI (including deep incisional or organ/space), caused by S. aureus, occurred within 90 days of post elective open posterior spinal fusion surgery with multilevel instrumentation, as confirmed by event adjudication committee (EAC) have been reported. A participant may have met criteria for both BSI and SSI (deep incisional or organ/space).
Number of Participants With Adverse Events (AEs) From The Day of Surgery (Day 1) Until First Postoperative Evaluation on Day 42 Day of surgery (Day 1) up to Day 42 after surgery An AE was any untoward medical occurrence in a participant who received study vaccine without regard to possibility of causal relationship. AEs including serious as well non-serious AEs.
Number of Participants With Newly Diagnosed Chronic Medical Disorders From First Postoperative Evaluation on Day 42 Until Last Postoperative Evaluation on Day 180 Day 42 up to Day 180 (up to 138 days) A newly diagnosed chronic medical disorder was defined as a disease or medical condition, not previously identified, that was expected to be persistent or otherwise long-lasting in its effects.
- Secondary Outcome Measures
Name Time Method Number of Participants With Any Postoperative S. Aureus Surgical-site Infection (SSI-Superficial, Deep Incisional or Organ/Space) Occurred Within 180 Days After Surgery Day of surgery (Day 1) up to Day 180 after surgery SSI: infection at a surgical incision. Types of SSI in this outcome measure: Superficial SSI: Infection involved only skin and subcutaneous tissue of the incision, Deep incisional SSI: infection involved deep soft tissues of incision (e.g. fascial and muscle layers), Organ/space SSI: infection involved any part of body, excluding skin incision, fascia, or muscle layers, that was opened or manipulated during operative procedure. Overall number of participants with postoperative SSI (including superficial, deep incisional and/or organ/space SSI) caused by S. aureus, occurred within 180 days after elective open posterior spinal fusion surgery with multilevel instrumentation as confirmed by EAC have been reported.
Number of Participants With Postoperative S. Aureus Blood Stream Infection (BSI) And/or Surgical-site Infection (SSI-Including Deep Incisional or Organ/Space) Occurred Within 180 Days After Surgery Day of surgery (Day 1) up to Day 180 after surgery BSI: clinical infection involved a recognized pathogen (S. aureus) cultured from 1 or more blood cultures or a commensal organism cultured from 2 or more blood cultures whether primary or secondary to infection at another site. SSI: infection at a surgical incision. Types of SSI in this outcome measure: Deep incisional SSI: infection involved deep soft tissues of incision (e.g. fascial and muscle layers), Organ/space SSI: infection involved any part of body excluding skin incision, fascia or muscle layers, that was opened or manipulated during operative procedure. Overall number of participants with postoperative BSI and/or SSI (including deep incisional or organ/space), caused by S. aureus, occurred within 180 days of post elective open posterior spinal fusion surgery with multilevel instrumentation, as confirmed by EAC have been reported. A participant may have met criteria for both BSI and SSI (deep incisional or organ/space).
Number of Participants With Any Postoperative S. Aureus Surgical-site Infection (SSI-Superficial, Deep Incisional or Organ/Space) Occurred Within 90 Days After Surgery Day of surgery (Day 1) up to Day 90 after surgery SSI: infection at a surgical incision. Types of SSI in this outcome measure: Superficial SSI: Infection involved only skin and subcutaneous tissue of the incision, Deep incisional SSI: infection involved deep soft tissues of incision (e.g. fascial and muscle layers), Organ/space SSI: infection involved any part of body, excluding skin incision, fascia, or muscle layers, that was opened or manipulated during operative procedure. Overall number of participants with postoperative SSI (including superficial, deep incisional and/or organ/space SSI) caused by S. aureus, occurred within 90 days after elective open posterior spinal fusion surgery with multilevel instrumentation as confirmed by EAC have been reported.
Trial Locations
- Locations (292)
Anne Arundel Medical Group Orthopedics and Sports Medicine Specialists
🇺🇸Pasadena, Maryland, United States
Seton Medical Center Williamson
🇺🇸Round Rock, Texas, United States
The Rothman Institute
🇺🇸Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
Ronald Reagan UCLA Medical Center
🇺🇸Los Angeles, California, United States
University of Maryland, Medical Systems, Oriole Park
🇺🇸Baltimore, Maryland, United States
USC Spine Center
🇺🇸Los Angeles, California, United States
Clinical Office
🇺🇸Los Angeles, California, United States
Emory University Clinic
🇺🇸Atlanta, Georgia, United States
University of Illinois Hospital and Health Sciences System - Hospital Pharmacy Services
🇺🇸Chicago, Illinois, United States
Rush University Medical Center Professional Office Building Infusion Pharmacy
🇺🇸Chicago, Illinois, United States
Rush University Medical Center Pharmacy
🇺🇸Chicago, Illinois, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
John Hopkins Hospital
🇺🇸Baltimore, Maryland, United States
The Johns Hopkins Hospital Investigational Drug Service
🇺🇸Baltimore, Maryland, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Remington-Davis, Inc.
🇺🇸Columbus, Ohio, United States
Allegheny General Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Upmc (Puh/Muh)
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Presbyterian
🇺🇸Pittsburgh, Pennsylvania, United States
Orthopedic One
🇺🇸Columbus, Ohio, United States
NYU Langone Health Orthopedic Center
🇺🇸New York, New York, United States
NYU Langone Health Tisch Hospital
🇺🇸New York, New York, United States
The Clinical Research Unit at Mount Sinai
🇺🇸New York, New York, United States
Cleveland Clinic Foundation Center for Spine Health
🇺🇸Cleveland, Ohio, United States
Riverside Methodist Hospital Pharmacy
🇺🇸Columbus, Ohio, United States
Milton S. Hershey Medical Center Pharmacy
🇺🇸Hershey, Pennsylvania, United States
Carolina Neurosurgery and Spine Associates, P.A.
🇺🇸Charlotte, North Carolina, United States
UHS Neurosurgery
🇺🇸Johnson City, New York, United States
Kimmel Pavillion
🇺🇸New York, New York, United States
NYU Langone Madison Ave. Orthopedics
🇺🇸New York, New York, United States
OrthoCarolina Hip & Knee Center
🇺🇸Charlotte, North Carolina, United States
UHS Wilson Medical Center
🇺🇸Johnson City, New York, United States
OrthoCarolina
🇺🇸Charlotte, North Carolina, United States
Northwell Health Physician Partners- Department of Neurosurgery Spine @Lynbrook
🇺🇸Lynbrook, New York, United States
Dublin Methodist Hospital
🇺🇸Dublin, Ohio, United States
NYU Langone Health Orthopedic Hospital
🇺🇸New York, New York, United States
Novant Health Charlotte Orthopedic Hospital/Presbyterian Orthopedic Hospital
🇺🇸Charlotte, North Carolina, United States
lcahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
OrthoCarolina Ballantyne
🇺🇸Charlotte, North Carolina, United States
The Feinstein Institute for Medical Research
🇺🇸Manhasset, New York, United States
North Shore University Hospital
🇺🇸Manhasset, New York, United States
Hospital for Special Surgery
🇺🇸New York, New York, United States
NYU Langone Seaport Orthopaedics
🇺🇸New York, New York, United States
Investigational Drug Service Pharmacy
🇺🇸Philadelphia, Pennsylvania, United States
Rothman Institute-Chalfont Office
🇺🇸Chalfont, Pennsylvania, United States
Abington Jefferson Health-Pharmacy Department
🇺🇸Abington, Pennsylvania, United States
Abington Jefferson Health
🇺🇸Abington, Pennsylvania, United States
Neurosurgical Specialist of Texas
🇺🇸Fredericksburg, Texas, United States
St. David's Round Rock Medical Center
🇺🇸Round Rock, Texas, United States
CHU Pellegrin, Pharmacie
🇫🇷Bordeaux, France
University of Virginia Health System
🇺🇸Charlottesville, Virginia, United States
Carilion Clinic - Department of Pharmacy
🇺🇸Roanoke, Virginia, United States
VCU Medical Center Investigational Drug Service
🇺🇸Richamond, Virginia, United States
St, Michael's Hospital - St. Michael's Pharmacy
🇨🇦Toronto, Ontario, Canada
Inova Neurosciences Research
🇺🇸Falls Church, Virginia, United States
Carilion Assessment, Registration and Education for Surgery (C.A.R.E.S)
🇺🇸Roanoke, Virginia, United States
Foothills Medical Centre, University of Calgary
🇨🇦Calgary, Alberta, Canada
WVU Medicine Physician Office Center
🇺🇸Morgantown, West Virginia, United States
Sentara Norfolk General Hospital
🇺🇸Norfolk, Virginia, United States
CHU de Nantes - Hotel Dieu
🇫🇷Nantes Cedex 1, France
CHU Pellegrin Tripode
🇫🇷Bordeaux, France
VCU Health
🇺🇸Richmond, Virginia, United States
Sentara Medical Group DBA Sentara Neurosurgery Specialists
🇺🇸Norfolk, Virginia, United States
Carilion Clinic Riverside 3
🇺🇸Roanoke, Virginia, United States
St. Michael's Hospital
🇨🇦Toronto, Ontario, Canada
CHU de Rennes - Hopital Pontchaillou
🇫🇷Rennes, Cedex 9, France
Klinikum rechts der Isar, Technische Universitat Munchen
🇩🇪Munchen, Germany
Hospital ClĂnico Universitario Santiago de Compostela
🇪🇸Santiago de Compostela, A Coruna, Spain
Montreal Neurological Institute and Hospital
🇨🇦Montreal, Quebec, Canada
CHU de Dijon
🇫🇷Dijon, France
AP-HM Hopital Nord
🇫🇷Marseille Cedex 20, France
Hospital Ramon Y Cajal
🇪🇸Madrid, Spain
Uniklinik Koeln
🇩🇪Koeln, Germany
The Ottawa Hospital, Civic Campus
🇨🇦Ottawa, Ontario, Canada
Hospital Universitario Fundacion Alcorcon
🇪🇸Alcorcon, Madrid, Spain
Klinikum rechts der Isar
🇩🇪Munchen, Germany
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
GHP Stockholm Spine Center
🇸🇪Upplands Vasby, Sweden
CHU de Rennes
🇫🇷Rennes, France
Pharmacy Store
🇬🇧Middlesbrough, Cleveland, United Kingdom
Centre for Spinal Studies and Surgery
🇬🇧Nottingham, United Kingdom
Charite- University Medicine Berlin
🇩🇪Berlin, Germany
Pharmacy Service of Hospital Clinico de Valladolid
🇪🇸Valladolid, Spain
Pharmacy Store, Main Pharmacy
🇬🇧Middlesbrough, Cleveland, United Kingdom
The James Cook University Hospital
🇬🇧Middlesbrough, Cleveland, United Kingdom
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Hospital Universitario Politecnico La Fe
🇪🇸Valencia, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Mermorial Hermann - Memorial City Medical Center
🇺🇸Houston, Texas, United States
Virginia Mason Medical Center
🇺🇸Seattle, Washington, United States
University of Miami Hospital
🇺🇸Miami, Florida, United States
The Christ Hospital
🇺🇸Cincinnati, Ohio, United States
The Lindner Center for Research and Education at The Christ Hospital
🇺🇸Cincinnati, Ohio, United States
University of California, San Francisco
🇺🇸San Francisco, California, United States
Twin Cities Spine Surgeons dba Twin Cities Spine Center
🇺🇸Minneapolis, Minnesota, United States
Allina Health - Abbott Northwestern Hospital /
🇺🇸Minneapolis, Minnesota, United States
Duke University Hospital, IDS Pharmacy
🇺🇸Durham, North Carolina, United States
Duke University Hospital
🇺🇸Durham, North Carolina, United States
Icahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
Clinical Office - Jason Cuellar M.D.
🇺🇸Beverly Hills, California, United States
Memorial Orthopaedic Surgical Group
🇺🇸Long Beach, California, United States
IDS Pharmacy-USC Norris Comprehensive Cancer Center and Hospital
🇺🇸Los Angeles, California, United States
USC/Department of Neurological Surgery
🇺🇸Los Angeles, California, United States
Cedars-Sinai Medical Center - Investigational Drug
🇺🇸Los Angeles, California, United States
Cedars-Sinai Medical Center
🇺🇸Los Angeles, California, United States
The Spine Center at Cedars-Sinai, Mark Goodson Building, Cedars-Sinai Medical Center
🇺🇸Los Angeles, California, United States
Ronald Reagan Med Center - University of California, Los Angeles (UCLA)
🇺🇸Los Angeles, California, United States
Kaiser Permanente Pediatric Clinic
🇺🇸Oakland, California, United States
University of California Irvine Medical Center
🇺🇸Orange, California, United States
UCLA CTRC Outpatient Unit
🇺🇸Los Angeles, California, United States
Kaiser Permanente Vaccine Study Center
🇺🇸Oakland, California, United States
UCLA Spine Center
🇺🇸Santa Monica, California, United States
Santa Monica UCLA Medical Center & Orthopaedic Hospital
🇺🇸Santa Monica, California, United States
UCLA Santa Monica Infectious Disease
🇺🇸Santa Monica, California, United States
LA BioMed at Harbor-UCLA Medical Center
🇺🇸Torrance, California, United States
LA BioMed, Harbor-UCLA Medical Center
🇺🇸Torrance, California, United States
Harbor-UCLA Medical Center
🇺🇸Torrance, California, United States
Boulder Community Health
🇺🇸Boulder, Colorado, United States
Boulder Community Health - Foothills Hospital
🇺🇸Boulder, Colorado, United States
Justin Parker Neurological Institute
🇺🇸Boulder, Colorado, United States
University of Colorado Hospital, Lone Tree Health Center
🇺🇸Lone Tree, Colorado, United States
The B.A.C.K. Center
🇺🇸Melbourne, Florida, United States
Holmes Regional Medical Center
🇺🇸Melbourne, Florida, United States
University of Miami Hospital and Clinics and Research Pharmacy
🇺🇸Miami, Florida, United States
Melbourne Regional Medical Center
🇺🇸Melbourne, Florida, United States
Gulfcoast Research Institute, LLC
🇺🇸Sarasota, Florida, United States
Emory Orthopaedics & Spine Center
🇺🇸Atlanta, Georgia, United States
Emory Orthopaedics & Spine Hospital
🇺🇸Tucker, Georgia, United States
Snake River Research, PLLC
🇺🇸Idaho Falls, Idaho, United States
University of Illinois Hospital and Health Sciences System
🇺🇸Chicago, Illinois, United States
Rush University Medical Center (RUMC) / Midwest Orthopedics at Rush University Medical Center (RUMC)
🇺🇸Chicago, Illinois, United States
University of Iowa Hospitals and Clinics
🇺🇸Iowa City, Iowa, United States
University of Kansas Hospital
🇺🇸Kansas City, Kansas, United States
Anne Arundel Health System Research Institute (AAHSRI)
🇺🇸Annapolis, Maryland, United States
Anne Arundel Medical Center Infusion Center
🇺🇸Annapolis, Maryland, United States
Anne Arundel Medical Center Laboratory
🇺🇸Annapolis, Maryland, United States
University of Maryland Medical Systems, Department of Neurosurgery
🇺🇸Baltimore, Maryland, United States
University of Maryland Medical Systems, Investigational Drug Services
🇺🇸Baltimore, Maryland, United States
John Hopkins Bayview Medical Center
🇺🇸Baltimore, Maryland, United States
Johns Hopkins Bayview Medical Center
🇺🇸Baltimore, Maryland, United States
Department of Orthopedic Surgery, The Johns Hopkins Outpatient Center
🇺🇸Baltimore, Maryland, United States
Massachusetts General Hospital, Clinical Research Pharmacy
🇺🇸Boston, Massachusetts, United States
Brigham and Women's Hospital Investigational Drug Services (IDS)
🇺🇸Boston, Massachusetts, United States
Brigham and Women's Hospital
🇺🇸Boston, Massachusetts, United States
UMass Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
UMass Memorial Medical Center- Clinical Research Center
🇺🇸Worcester, Massachusetts, United States
University of Massachusetts Medical Center Memorial Campus
🇺🇸Worcester, Massachusetts, United States
Butterworth Hospital
🇺🇸Grand Rapids, Michigan, United States
Blodgett Hospital
🇺🇸Grand Rapids, Michigan, United States
Bronson Methodist Hospital
🇺🇸Kalamazoo, Michigan, United States
Orthopaedic Associates of Michigan - Research
🇺🇸Grand Rapids, Michigan, United States
Bronson Spine and Scoliosis Specialists
🇺🇸Kalamazoo, Michigan, United States
Michigan Orthopaedic & Spine Surgeons
🇺🇸Rochester Hills, Michigan, United States
Beaumont Orthopaedic Center
🇺🇸Royal Oak, Michigan, United States
William Beaumont Hospital
🇺🇸Royal Oak, Michigan, United States
Michigan Orthopaedic Institute
🇺🇸West Bloomfield, Michigan, United States
Center for Outpatient Health
🇺🇸Saint Louis, Missouri, United States
Barnes Jewish Hospital
🇺🇸Saint Louis, Missouri, United States
Barnes Jewish Center for Advanced Medicine
🇺🇸Saint Louis, Missouri, United States
Barnes Jewish Pharmacy
🇺🇸Saint Louis, Missouri, United States
Barnes-Jewish Pharmacy
🇺🇸Saint Louis, Missouri, United States
Washington University
🇺🇸Saint Louis, Missouri, United States
Ambulatory Care Center
🇺🇸Newark, New Jersey, United States
University Hospital - Pharmacy
🇺🇸Newark, New Jersey, United States
Doctors Office Center-Rutgers, The State University of New Jersey-New Jersey Medical School
🇺🇸Newark, New Jersey, United States
Northwell Health Physician Partners- Department of Neurosurgery Spine @Great Neck
🇺🇸Great Neck, New York, United States
NYU Langone Huntington Medical Group
🇺🇸Huntington Station, New York, United States
OrthoCarolina Pineville
🇺🇸Charlotte, North Carolina, United States
OrthoCarolina Matthews
🇺🇸Matthews, North Carolina, United States
Cleveland Clinic Foundation - Investigation Pharmacy
🇺🇸Cleveland, Ohio, United States
Penn State College of Medicine and Penn State Hershey Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
Jefferson Hospital For Neuroscience
🇺🇸Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital - Pre-Admission Testing Center
🇺🇸Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital, Cardiovascular Associates
🇺🇸Philadelphia, Pennsylvania, United States
Rothman Institute-Willow Grove Office
🇺🇸Willow Grove, Pennsylvania, United States
Hermann Drive Surgical Hospital
🇺🇸Houston, Texas, United States
Baylor College of Medicine - McNair Campus
🇺🇸Houston, Texas, United States
Baylor Scott & White Medical Center
🇺🇸Plano, Texas, United States
Scott & White Memorial Hospital and Clinic (Scott & White Roney Bone & Joint Institute)
🇺🇸Temple, Texas, United States
Clinical Alliance for Research and Education - Infectious Diseases, LLC (CARE-ID)
🇺🇸Annandale, Virginia, United States
Scott & White Memorial Hospital and Clinic
🇺🇸Temple, Texas, United States
Inova Fairfax Hospital
🇺🇸Falls Church, Virginia, United States
Inova Fair Oaks Hospital
🇺🇸Fairfax, Virginia, United States
Carilion Clinic Institute for Orthopaedics and Neurosciences
🇺🇸Roanoke, Virginia, United States
Carilion Roanoke Memorial Hospital
🇺🇸Roanoke, Virginia, United States
Foothills Medical Centre
🇨🇦Calgary, Alberta, Canada
Toronto Western Hospital
🇨🇦Toronto, Ontario, Canada
CHU Hopital d'Enfants
🇫🇷Dijon, France
CHU de Nimes
🇫🇷Nîmes Cedex 9, France
CIC Cochin/Pasteur (CIC 1417)
🇫🇷Paris, France
CHU de Nimes - Caremeau
🇫🇷Nîmes Cedex 9, France
Service de Pharmacie
🇫🇷Paris, France
Hopital Civil
🇫🇷Strasbourg, France
Hopitaux Universitaires de Strasbourg
🇫🇷Strasbourg, France
St. Franziskus Hospital Munster
🇩🇪Munster, Germany
National Hospital Organization Hokkaido Medical Center
🇯🇵Sapporo, Hokkaido, Japan
Detroit Receiving Hospital, Heart Hospital, Harper Hospital at
🇺🇸Detroit, Michigan, United States
Barrow Brain and Spine
🇺🇸Phoenix, Arizona, United States
St. Joseph's Hospital and Medical Center
🇺🇸Phoenix, Arizona, United States
The University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States
OHSU Research Pharmacy
🇺🇸Portland, Oregon, United States
Oregon Health and Sciences University
🇺🇸Portland, Oregon, United States
Mayo Clinic Hospital, Methodist Campus
🇺🇸Rochester, Minnesota, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Service de Chirurgie Orthopedique et Traumatologie
🇫🇷Paris, France
AP-HM La Timone - Hopital adultes
🇫🇷Marseille Cedex 5, France
Unite d'investigation clinique
🇫🇷Rennes, Cedex 9, France
Hopital Nord-CHU Saint Etienne
🇫🇷Saint Priest en Jarez, France
Montreal Neurological Hospital Research Pharmacy
🇨🇦Montreal, Quebec, Canada
Shimonoseki City Hospital
🇯🇵Shimonoseki-shi, Yamaguchi, Japan
Japan Community Health care Organization Osaka Hospital
🇯🇵Osaka, Japan
Orszagos Gerincgyogyaszati Kozpont
đź‡đź‡şBudapest, Hungary
Bingham Memorial Specialty Clinic
🇺🇸Idaho Falls, Idaho, United States
University Medical Center of Southern Nevada
🇺🇸Las Vegas, Nevada, United States
Eastern Idaho Regional Medical Center
🇺🇸Idaho Falls, Idaho, United States
Cancer Center, Rutgers, The State University of New Jersey-New Jersey Medical School
🇺🇸Newark, New Jersey, United States
University Hospital
🇺🇸Newark, New Jersey, United States
Brent H. Greenwald, M.D. Neurological Surgery
🇺🇸Idaho Falls, Idaho, United States
Meridian Hospitals Corp c/o Jersey Shore University Medical Center
🇺🇸Neptune, New Jersey, United States
Tirol Kliniken
🇦🇹Innsbruck, Austria
Japan Organization of Occupational Health and Safety, Kanto Rosai Hospital
🇯🇵Kawasaki, Kanagawa, Japan
Nagasaki Rosai Hospital
🇯🇵Sasebo, Nagasaki, Japan
National Hospital Organization Murayama Medical Center
🇯🇵Musashimurayama, Tokyo, Japan
Greenbaum Surgical Specialty Hospital
🇺🇸Scottsdale, Arizona, United States
Bingham Memorial Hospital
🇺🇸Blackfoot, Idaho, United States
WVU Medicine JW Ruby Memorial Hospital In-Patient Pharmacy
🇺🇸Morgantown, West Virginia, United States
Baylor College of Medicine
🇺🇸Houston, Texas, United States
The Rothman Institute Marlton, NJ Office
🇺🇸Marlton, New Jersey, United States
HonorHealth Scottsdale Osborn Medical Center
🇺🇸Scottsdale, Arizona, United States
Physicians & Surgeons Clinic
🇺🇸Pocatello, Idaho, United States
The Rothman Institute Washington Township, NJ Office
🇺🇸Sewell, New Jersey, United States
Hakodate Central General Hospital
🇯🇵Hakodate, Hokkaido, Japan
WVU Medicine Spine Center
🇺🇸Morgantown, West Virginia, United States
Bingham Memorial Family Medicine & Specialty Clinic
🇺🇸Pocatello, Idaho, United States
HackensackUMC Mountainside Hospital
🇺🇸Montclair, New Jersey, United States
Spine Institute of Louisiana
🇺🇸Shreveport, Louisiana, United States
WVU Medicine JW Ruby Memorial Hospital
🇺🇸Morgantown, West Virginia, United States
WVU Medicine Physician Office Center Orthopaedic Surgery
🇺🇸Morgantown, West Virginia, United States
Montreal General Hospital Research Institute of the MUHC- MGH Pharmacy Research
🇨🇦Montreal, Quebec, Canada
MHAT "Sveta Marina" EAD
🇧🇬Varna, Bulgaria
Saiseikai Kawaguchi General Hospital
🇯🇵Kawaguchi, Saitama, Japan
Seirei Hamamatsu General Hospital
🇯🇵Hamamatsu, Shizuoka, Japan
Hospital Universitari Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
Musashino Red Cross Hospital
🇯🇵Musashino, Tokyo, Japan
South Tees Hospitals NHS Foundation Trust
🇬🇧Middlesbrough, Cleveland, United Kingdom
Salford Royal NHS Foundation Trust
🇬🇧Salford, Greater Manchester, United Kingdom
Southampton General Hospital
🇬🇧Southampton, United Kingdom
Hospital Clinico Universitario de Valladolid
🇪🇸Valladolid, Spain
Mayo Clinic Rochester, Methodist Hospital Campus
🇺🇸Rochester, Minnesota, United States
Keck Hospital of USC
🇺🇸Los Angeles, California, United States
Seton Brain and Spine Institute Williamson
🇺🇸Round Rock, Texas, United States
CHI St. Luke's Health Baylor College of Medicine Medical Center
🇺🇸Houston, Texas, United States
Inova Medical Group
🇺🇸Fairfax, Virginia, United States
Mountain View Hospital
🇺🇸Idaho Falls, Idaho, United States
University of Colorado Clinical & Translational Research Center Clinic
🇺🇸Aurora, Colorado, United States
University of Colorado Denver, School of Medicine
🇺🇸Aurora, Colorado, United States
University of Colorado Department of Pharmacy AIP 2, Pharmacy Bulk Storage
🇺🇸Aurora, Colorado, United States
University of Colorado Hospital
🇺🇸Aurora, Colorado, United States
Yale New Haven Hospital - Investigational Drug Services
🇺🇸New Haven, Connecticut, United States
Yale New Haven Hospital
🇺🇸New Haven, Connecticut, United States
Yale New Haven Hospital - St. Raphael campus
🇺🇸New Haven, Connecticut, United States
Ycci-Csru
🇺🇸New Haven, Connecticut, United States
Yale-New Haven Hospital Spine Center
🇺🇸New Haven, Connecticut, United States
Florida Hospital Orlando
🇺🇸Orlando, Florida, United States
Neuroscience ACS Research
🇺🇸Orlando, Florida, United States
Florida Hospital Orlando - Florida Hospital Investigational Drug Pharmacy
🇺🇸Orlando, Florida, United States
Norton Healthcare Pharmacy
🇺🇸Louisville, Kentucky, United States
Norton Hospital
🇺🇸Louisville, Kentucky, United States
Norton Leatherman Spine Center
🇺🇸Louisville, Kentucky, United States
University of Michigan Investigational Pharmacy
🇺🇸Ann Arbor, Michigan, United States
University Of Michigan Hospitals
🇺🇸Ann Arbor, Michigan, United States
Ochsner Baptist Medical Center
🇺🇸New Orleans, Louisiana, United States
Dell Seton Medical Center at The University of Texas
🇺🇸Austin, Texas, United States
Austin Infectious Disease Consultants
🇺🇸Austin, Texas, United States
Employee Wellness Center
🇺🇸Austin, Texas, United States
St. David's North Austin Medical Center
🇺🇸Austin, Texas, United States
VCU Heatlh Neuroscience Orthopedic and Wellness Center
🇺🇸Richmond, Virginia, United States
VCU Health Ambulatory Care Center
🇺🇸Richmond, Virginia, United States
Ochsner Clinic Foundation
🇺🇸New Orleans, Louisiana, United States
Seton Medical Center Austin
🇺🇸Austin, Texas, United States
St. David's Medical Center
🇺🇸Austin, Texas, United States
St. David's Neuroscience and Spine Institute
🇺🇸Austin, Texas, United States
Seton Spine and Scoliosis Center
🇺🇸Austin, Texas, United States
Wellness Brain and Spine
🇺🇸Austin, Texas, United States
Beaumont Health-Troy
🇺🇸Troy, Michigan, United States
Scott & White Memorial Hospital
🇺🇸Temple, Texas, United States
AAMC Research Pharmacy
🇺🇸Annapolis, Maryland, United States
OrthoVirginia
🇺🇸McLean, Virginia, United States
Thomas Jefferson University
🇺🇸Philadelphia, Pennsylvania, United States
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
Tirol Kliniken GmbH
🇦🇹Innsbruck, Austria