A Phase 3 Randomized, Double-Blind Study of Ceftobiprole Medocaril versus Linezolid Plus Ceftazidime in the Treatment of Nosocomial Pneumonia - CHOPIN-1
- Conditions
- Hospital-Acquired or Nosocomial Pneumonia
- Registration Number
- EUCTR2005-004174-24-CZ
- Lead Sponsor
- Johnson&Johnson Pharmaceutical Research&Development, L.L.C.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 0
1. Written informed consent provided. Consent may be given for unconscious/incapacitated subjects by their next of kin, guardian, or legal representative according to local regulatory and ethical practice using a subject information sheet and informed consent form approved by the responsible Ethics Committee.
2. Male or female subjects aged =18 years
3. Female subjects must be postmenopausal (for at least 1 year), surgically sterile (have had a hysterectomy or bilateral oophorectomy, tubal ligation, or otherwise be incapable of pregnancy), or practicing an effective method of birth control (e.g., prescription oral contraceptives, contraceptive injections or patch, intrauterine device, double-barrier method [e.g., condoms, diaphragm, or cervical cap with spermicidal foam, cream, or gel], male partner sterilization or, at the discretion of the investigator, abstinence), before entry and throughout the study; and have a negative serum or urine pregnancy test (depending on local regulations) at screening.
4. Subjects suffering from NP or VAP defined as follows:
Nosocomial Pneumonia
(Subjects must have a, b, c, and d)
a) Clinical diagnosis of pneumonia after a minimum of 72 hours of hospitalization or in a chronic care facility
Exceptions would include:
– =48 to <72 hours of hospitalization or in a chronic care facility, if at admission no acute inflammatory pulmonary infiltrate was present, WBC and differential blood count was normal, and the reason for admission was not an infection, OR
– discharge from hospital or chronic care facility =48 hours after a stay of =72 hours.
b) Clinical signs or symptoms of pneumonia with AT LEAST 2 of the following criteria:
• New onset of purulent sputum production or respiratory secretions or a worsening in character of sputum.
• Tachypnea (respiratory rate =20/minute), particularly if progressive in nature.
• Hypoxemia with a P02=60 mmHg while subject is breathing on room air, as determined by pulse oximetry or arterial blood gas, or alveolar arterial O2 gradient, or respiratory failure requiring mechanical ventilation.
c) New or persistent (persistence is defined as the infiltrate being radiographically visible for at least 72 hours) radiographic infiltrates (not related to another disease process)
d) Fever or leukocytosis/leukopenia consistent with a diagnosis of pneumonia with AT
LEAST 1 of the following:
• Fever ([in the absence of antipyretics], increase in core temperature of >1°C OR an oral temperature >38°C, a tympanic temperature >38.5°C, a rectal/core temperature >39°C, OR hypothermia, defined as a rectal/core body temperature of <35°C).
• Leukocytosis (a total WBC count =10 x 109/L or =15% immature neutrophils [bands], regardless of total peripheral white count; or leukopenia with total WBC =4.5 x 109/L).
5. Microbiological samples (respiratory secretions) suitable for culture and microscopy
6. APACHE II score =8 and =25
7. Subjects with NP (as defined above) who developed pneumonia more than 48 hours after onset of mechanical ventilation.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range
1. Female subjects who are pregnant or lactating.
2. Known or suspected hypersensitivity to any related anti-infective (including ß-lactam antibiotics such as penicillins, cephalosporins, oxazolidinones, or monobactams)
3. Any known or suspected condition or concurrent treatment that would be contraindicated by the prescribing information for linezolid (any medicinal product which inhibits monoamine oxidases A or B, [e.g., phenelzine, isocarboxazid, selegiline, moclobemide] or within 2 weeks of taking any such medicinal product) or ceftazidime.
Exception: Subjects with underlying conditions and/or on concomitant medications that might put them at risk from MAO inhibition can only be enrolled if they are hospitalized.
4. Known or suspected severe renal impairment, (calculated creatinine clearance [CrCl] <30 mL/minute or oliguria <20 mL/hour unresponsive to fluid challenge) or any form of dialysis.
5. Known or suspected hepatic dysfunction (total bilirubin, or alanine aminotransferase [ALT], or aspartate aminotransferase [AST] =3 times upper limit of the normal range [ULN]).
6. QTcB (Bazett’s correction) >450 msec at baseline
7. Previous enrollment in this study.
8. Treatment with any investigational drug within 30 days before enrollment.
9. Any other known or suspected condition of the subject that may jeopardize adherence to protocol requirements (e.g., severe chronic obstructive pulmonary disease [COPD], NYHA Class 4 cardiac disease, burn subjects with >15% total body burn or any significant third degree burn).
10. Known to be HIV-positive with CD4 counts of =0.2x109/L (=200 cells/mm3). (Subjects with HIV and >0.2x109/L [>200 cells/mm3] may be included).
11. Presence of myelosuppression or neutropenia (absolute neutrophil count [ANC] =0.5x109/L [<500 PMNs/mm3]), severe anemia (hemoglobin <6.5 g/dL, or severe
thrombocytopenia (<49.9x109/cm). Note: subjects receiving immunosuppressive therapy who are expected to reach a nadir of <500 PMNs/mm3 during administration of study drug should not be enrolled.
12. Children or other family members of the investigator or of employees of the study center, with
direct involvement in the proposed study or other studies under the direction of that investigator or study center.
13. Sustained shock (e.g., systolic BP <90 mmHg for >2 hours despite adequate fluid resuscitation, with evidence of hypoperfusion or need for sympathomimetic agents).
14. Subjects with either
- known bronchial obstruction or a history of postobstructive pneumonia (mild and moderate COPD subjects are allowed) including primary lung cancer or another malignancy metastatic to the lungs,
- cystic fibrosis,
- lung abscess,
- pleural effusion as a primary source of infection
- active tuberculosis, or
- subjects requiring antibiotic cover for aspiration pneumonia, atypical pneumonia (including Legionella pneumophila), or Pneumocystis jiroveci (carinii) pneumonia.
15. Systemic antimicrobial therapy for more than 24 hours in the 7 days prior to enrollment Exceptions: Systemic antimicrobial therapy for >24 hours is permitted in case of any of the following:
a) the infection is caused by microbiologically-confirmed pathogens that are resistant to the previous antimicrobial agents.
b) the subject is clinically deteriorating despite at least 72 hours of antibiotic therapy and is documented to be infected or colonized with a pathogen that is susceptible to both ceftobiprole and the comparator regimen.
c) the subject has received antibiotic th
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method