MK-7625A Plus Metronidazole Versus Meropenem in Pediatric Participants With Complicated Intra-Abdominal Infection (cIAI) (MK-7625A-035)
- Conditions
- Complicated Intra-Abdominal Infection
- Interventions
- Registration Number
- NCT03217136
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
This study aims to evaluate the safety and tolerability of MK-7625A (ceftolozane/tazobactam) plus metronidazole, compared with that of meropenem in pediatric participants with cIAI.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 94
- Has a legally acceptable representative who provides documented informed consent/assent for the trial.
- Aged from birth (defined as >32 weeks gestational age and ≥7 days postnatal) to <18 years of age.
- Require IV antibacterial therapy for the treatment of presumed or documented cIAI.
- Has an operative procedure for the current diagnosis and management of cIAI planned or completed within 24 hours of the first dose of an antibacterial drug. Note: Participants with a diagnosis of necrotizing enterocolitis are exempt and not required to have surgery planned or completed in order to be eligible.
- Has in compliance baseline intra-abdominal specimen collection.
- Is not of reproductive potential; but if of reproductive potential agrees to avoid becoming pregnant or impregnating a partner during screening, while receiving study treatment and for at least 30 days after the last dose of study treatment.
- Female of reproductive potential is not pregnant, and not planning to become pregnant within 30 days of the last day of treatment administration; and is nonlactating.
- Is currently participating in or has participated in an interventional clinical trial with an investigational compound or device within 30 days prior to the first dose of study treatment in this current trial.
- Has previously participated in any trial of ceftolozane or ceftolozane/tazobactam or has enrolled previously in the current trial and been discontinued.
- Has a history of any moderate or severe hypersensitivity (e.g, anaphylaxis), allergic reaction, or other contraindication to any of the following: β-lactam antibiotics (e.g, penicillins, cephalosporins, and carbapenems), β-lactamase inhibitors (e.g, tazobactam, sulbactam, clavulanic acid, avibactam), or metronidazole.
- Has an IAI within the past 1 year prior to randomization known to be caused by a pathogen resistant to either IV study treatment.
- Has a concomitant infection at the time of randomization that requires non-study systemic antibacterial therapy in addition to IV study treatment or oral step-down therapy.
- Has received potentially therapeutic antibacterial therapy for a duration more than 24 hours during the 48 hours preceding the first dose of study treatment, unless is considered to be failing antibiotic therapy for cIAI.
- Has any of the following: a) intractable cIAI that the investigator anticipates would require more than 14 days of study treatment; b) abdominal wall abscess; c) small bowel obstruction; d) ischemic bowel disease without perforation; e) traumatic bowel perforation with surgery within 12 hours of perforation; f) perforation of gastroduodenal ulcers requiring surgery within 24 hours of perforation; g) suspected uncomplicated intra-abdominal infection (e.g, cholecystitis without rupture or extension beyond the gallbladder wall); h) acute suppurative cholangitis; i) infected necrotizing pancreatitis; j) pancreatic abscess.
- Has moderate or severe impairment of renal function.
- Has a seizure disorder or is anticipated to be treated with divalproex sodium or valproic acid during the course of study treatment.
- Is receiving, or is expected to receive, any prohibited medications.
- Has any rapidly progressing disease or immediately life-threatening illness, including acute hepatic failure, respiratory failure, or septic shock.
- Has an immunocompromising condition.
- Has a history of malignancy ≤5 years prior to signing informed consent.
- Is planning to receive suppressive/prophylactic antibiotics with gram-negative activity after completion of study treatment.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Ceftolozane/Tazobactam + Metronidazole Ceftolozane/Tazobactam Ceftolozane 20 mg/kg and tazobactam 10 mg/kg (maximum 1 g and 0.5 g/dose), plus metronidazole 10 mg/kg (maximum 1.5 g/day) administered intravenously (IV) every 8 to 12 hours for 5 to 14 days. Meropenem + Placebo for Metronidazole Placebo for Metronidazole Meropenem 20 mg/kg (maximum 1 g/dose) plus placebo for Metronidazole administered IV every 8 hours for 5 to 14 days. Ceftolozane/Tazobactam + Metronidazole Metronidazole Ceftolozane 20 mg/kg and tazobactam 10 mg/kg (maximum 1 g and 0.5 g/dose), plus metronidazole 10 mg/kg (maximum 1.5 g/day) administered intravenously (IV) every 8 to 12 hours for 5 to 14 days. Meropenem + Placebo for Metronidazole Meropenem Meropenem 20 mg/kg (maximum 1 g/dose) plus placebo for Metronidazole administered IV every 8 hours for 5 to 14 days.
- Primary Outcome Measures
Name Time Method Number of Participants Experiencing ≥1 Adverse Events (AEs) Up to approximately 75 days An AE was defined as any untoward medical occurrence in a participant administered study treatment and which did not necessarily have to have a causal relationship with this treatment. The number of participants who experienced an AE is presented.
Number of Participants Who Discontinued Study Therapy Due to AE(s) Up to approximately 18 days An AE was defined as any untoward medical occurrence in a participant administered study treatment and which did not necessarily have to have a causal relationship with this treatment. The number of participants who discontinued study treatment due to an AE is presented.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With a Clinical Response of "Cure" at the End of Treatment (EOT) Visit Up to approximately 27 days The percentage of participants who had a clinical outcome of "cure" at the time of the EOT visit is presented. The "cure" clinical outcome was defined as complete resolution or marked improvement in signs and symptoms of the complicated intra-abdominal infection (cIAI) or return to pre-infection signs and symptoms such that no further antibiotic therapy (intravenous or oral) or surgical or drainage procedure is required for treatment of the cIAI. Participants who were missing clinical response data were considered treatment failures.
Percentage of Participants With a Clinical Response of "Cure" at the Test of Cure (TOC) Visit Up to approximately 39 days The percentage of participants who had a clinical outcome of "cure" at the time of the TOC visit is presented. The "cure" clinical outcome was defined as complete resolution or marked improvement in signs and symptoms of the complicated intra-abdominal infection (cIAI) or return to pre-infection signs and symptoms such that no further antibiotic therapy (intravenous or oral) or surgical or drainage procedure is required for treatment of the cIAI. Participants who were missing clinical response data were considered treatment failures.
Percentage of Participants With Microbiological Eradication at the EOT Visit Up to approximately 27 days The percentage of participants who achieved either eradication or presumed eradication of each baseline infecting pathogen by the time of the EOT visit is presented. Eradication was defined as absence of the baseline pathogen(s) in a postbaseline specimen appropriately obtained from the original site of infection. Presumed eradication was defined as absence of material to culture in a participant who is assessed as having partial improvement, or clinical cure. In the event of multiple baseline pathogens, the least favorable microbiological response from all possible baseline pathogens was used.
Percentage of Participants With Microbiological Eradication at the TOC Visit Up to approximately 39 days The percentage of participants who achieved either eradication or presumed eradication of each baseline infecting pathogen by the time of the TOC visit is presented. Eradication was defined as absence of the baseline pathogen(s) in a postbaseline specimen appropriately obtained from the original site of infection. Presumed eradication was defined as absence of material to culture in a participant who is assessed as having partial improvement, or clinical cure. In the event of multiple baseline pathogens, the least favorable microbiological response from all possible baseline pathogens was used.
Trial Locations
- Locations (50)
Red Cross War Memorial Children's Hospital ( Site 1902)
🇿🇦Cape Town, Western Cape, South Africa
Universiti Kebangsaan Malaya Medical Centre ( Site 1101)
🇲🇾Cheras, Johor, Malaysia
Children's Hospital of Orange County ( Site 2502)
🇺🇸Orange, California, United States
Inst de Medicina Integral Professor Fernando Figueira- IMIP ( Site 0201)
🇧🇷Recife, Pernambuco, Brazil
Baptist Medical Center/Wolfson Children's Hospital ( Site 2521)
🇺🇸Jacksonville, Florida, United States
Hospital Pequeno Principe ( Site 0200)
🇧🇷Curitiba, Parana, Brazil
Heim Pal Orszagos Gyermekgyogyaszati Intezet ( Site 0806)
🇭🇺Budapest, Hungary
St. Louis Children's Hospital ( Site 2511)
🇺🇸Saint Louis, Missouri, United States
SUNY Upstate Medical University Hospital ( Site 2509)
🇺🇸Syracuse, New York, United States
Seattle Childrens Hospital ( Site 2510)
🇺🇸Seattle, Washington, United States
Hospital Tacchini ( Site 0203)
🇧🇷Bento Goncalves, Rio Grande Do Sul, Brazil
PTE AOK Klinikai Kozpont ( Site 0805)
🇭🇺Pecs, Baranya, Hungary
Klaipedos Vaiku Ligonine ( Site 1000)
🇱🇹Klaipeda, Lithuania
Vaiku Ligonine VU ligonines Santariskiu kliniku filialas ( Site 1002)
🇱🇹Vilnius, Lithuania
Debreceni Egyetem Klinikai Kozpont ( Site 0801)
🇭🇺Debrecen, Hungary
SZTE Szent-Gyorgyi Albert Klinikai Kozpont ( Site 0802)
🇭🇺Szeged, Hungary
Semmelweis Egyetem ( Site 0807)
🇭🇺Budapest, Hungary
University Malaya Medical Centre. ( Site 1100)
🇲🇾Kuala Lumpur, Malaysia
Instituto Tecnologico y de Estudios Superiores de Monterrey ( Site 1203)
🇲🇽Monterrey, Nuevo Leon, Mexico
Hospital Pulau Pinang ( Site 1102)
🇲🇾Georgetown, Pulau Pinang, Malaysia
Molotlegi Street ( Site 1901)
🇿🇦Pretoria, Gauteng, South Africa
Eskisehir Osmangazi Unv. Tip Fakultesi ( Site 2202)
🇹🇷Eskisehir, Turkey
Spitalul Clinic de Urgenta pentru Copii "Louis Turcanu" Timi ( Site 1701)
🇷🇴Timisoara, Timis, Romania
Stavropol Regional Pediatric Clinical Hospital ( Site 1805)
🇷🇺Stavropol, Stavropol Skiy Kray, Russian Federation
Hospital Universitario la Fe ( Site 2003)
🇪🇸Valencia, Valenciana, Comunitat, Spain
Cukurova Uni Tip Fak Cocuk Saglıgı ve Hasta ABD ( Site 2200)
🇹🇷Adana, Turkey
Hospital Clinico Universitario de Santiago ( Site 2001)
🇪🇸Santiago de Compostela, A Coruña [La Coruña], Spain
Rady Children's Hospital-San Diego ( Site 2505)
🇺🇸San Diego, California, United States
Primary Children's Hospital ( Site 2500)
🇺🇸Salt Lake City, Utah, United States
Children's Hospital - Los Angeles ( Site 2508)
🇺🇸Los Angeles, California, United States
Tufts Medical Center-Floating Hospital for Children ( Site 2516)
🇺🇸Boston, Massachusetts, United States
Smolensk Regional Clinical Hospital ( Site 1800)
🇷🇺Smolensk, Smolenskaya Oblast, Russian Federation
Hospital Infantil de Mexico Federico Gomez ( Site 1202)
🇲🇽Mexico City, Mexico
Hacettepe Universitesi Tip Fakultesi Hastanesi ( Site 2201)
🇹🇷Ankara, Turkey
Hospital Universitario Sant Joan de Deu ( Site 2000)
🇪🇸Esplugues de Llobregat, Barcelona, Spain
SBU Sariyer Hamidiye Etfal Egitim ve Arastirma Hastanesi ( Site 2203)
🇹🇷Istanbul, Turkey
PI Kryvorizka city clinical hospital 8 ( Site 2458)
🇺🇦Kryvyy Rig, Dnipropetrovska Oblast, Ukraine
SzSzBMK es Egyetemi Oktatokorhaz Josa Andras Oktatokorhaz ( Site 0804)
🇭🇺Nyiregyhaza, Szabolcs-Szatmar-Bereg, Hungary
Hospital of Lithuanian University of Health Sciences Kaunas ( Site 1001)
🇱🇹Kaunas, Lithuania
Instituto Nacional de Pediatria ( Site 1201)
🇲🇽Mexico City, Mexico
Hospital del Nino y Adolescente Morelense ( Site 1204)
🇲🇽Emiliano Zapata, Morelos, Mexico
Spit. Cl. de Urg. Copii Cluj Napoca ( Site 1703)
🇷🇴Cluj-Napoca, Cluj, Romania
Chelyabinsk Regional Children Clinical Hospital ( Site 1802)
🇷🇺Chelyabinsk, Chelyabinskaya Oblast, Russian Federation
Regional Childrens Clinical Hospital ( Site 1809)
🇷🇺Vologda, Vologodskaya Oblast, Russian Federation
National Children Specialised Hospital OHMADYT MOH Ukraine ( Site 2459)
🇺🇦Kyiv, Kyivska Oblast, Ukraine
Vinnytsya Regional Children Clinical Hospital ( Site 2463)
🇺🇦Vinnytsya, Vinnytska Oblast, Ukraine
SI Dnipropetrovsk Regional Children Clinical Hospital DOR ( Site 2452)
🇺🇦Dnipro, Dnipropetrovska Oblast, Ukraine
Municipal Institution City Children s Clinical Hospital of Poltava City Council ( Site 2454)
🇺🇦Poltava, Poltavska Oblast, Ukraine
Institut Catala d Oncologia Hospital Germans Trias i Pujol ( Site 2004)
🇪🇸Badalona, Barcelona, Spain
Ivano-Frankivsk Regional Children Clinical Hospital ( Site 2461)
🇺🇦Ivano-Frankivsk, Ivano-Frankivska Oblast, Ukraine