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临床试验/2024-518930-10-00
2024-518930-10-00尚未招募3 期

PYELOCOURT - 3-day intravenous antibiotic treatment versus 3-day intravenous followed by 7-day oral antibiotic treatment for acute pyelonephritis in children 1 month to 3 years old: a non-inferiority open randomized multicentric clinical trial

Assistance Publique Hopitaux De Paris1 个研究点 分布在 1 个国家目标入组 588 人开始时间: 2024年11月26日最近更新:
相关药物

试验速览

阶段
3 期
状态
尚未招募
入组人数
588
试验地点
1
主要终点
The primary endpoint is the occurrence of renal scaring, as measured by cortical defect by dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy at 6 months after the beginning of therapy (day 180 ± 15 days).

研究概览

简要总结

The main objective is to demonstrate the non-inferiority of a 3-day intravenous (IV) antibiotic therapy versus a 3-day IV therapy followed by a 7-day oral antibiotic therapy for the treatment of AP in children on the occurrence of renal scarring.

研究设计

研究类型
Interventional clinical trial of medicinal product

入排标准

年龄范围
0 years 至 17 years(0-17 Years)
接受健康志愿者

入选标准

  • Age ≥ 1 month and < 3 years o For children younger than 3 months, gestational age > 34 WA
  • First episode of urinary tract infection
  • AP defined by temperature ≥ 38°C on day of diagnosis AND positive urinalysis (white cell counts ≥ 104/mL)
  • Initial treatment by either ceftriaxone AND/OR amikacin
  • Outpatient or hospitalised

排除标准

  • Urine collected by bag
  • Known hypersensitivity to 99mTc-DMSA (medicinal product used for renal scintigraphy)
  • Known severe hepatic insufficiency
  • Known complete G6PD deficiency
  • No written consent from holders of parental authority
  • Non-affiliation to a social security system (as beneficiary or entitled person)
  • Children whose follow-up is not carried out in the centre
  • Participation in another interventional or minimal risk trial
  • Urine culture growing more than one dominant bacterium (cf section 6.2 of the protocol) Catheter-associated acute pyelonephritis
  • Known congenital anomalies of the kidney and genitourinary tract (other than vesicoureteral reflux and pyelocaliceal dilatation < 10 mm)
  • Previous surgery of the genitourinary tract (except circumcision in male children)
  • Abnormal renal function for age and weight (defined by a serum creatinine >40µmol/L before 1 year and >75µmol between 1 year et 3 years)
  • Known immunocompromising condition (e.g., HIV, primary immunodeficiency, sickle cell disease, use of chronic corticosteroids or other immunosuppressive agents)
  • Antibiotic prophylaxis for any reason OR antibiotic treatment in the last 7 days (except treatment administered for the AP)
  • Known hypersensitivity to at least one of the active substances /excipients: ceftriaxone (including cephalosporin and beta-lactams) and amikacin (including aminoside)
  • Known hypersensitivity to at least one of the active substances /excipients: cotrimoxazole (=sulfamethoxazole/trimethoprim) (including sulfonamide) and cefixime (including cephalosporin)

结局指标

主要结局

The primary endpoint is the occurrence of renal scaring, as measured by cortical defect by dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy at 6 months after the beginning of therapy (day 180 ± 15 days).

The primary endpoint is the occurrence of renal scaring, as measured by cortical defect by dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy at 6 months after the beginning of therapy (day 180 ± 15 days).

次要结局

  • - Clinical cure at the end of the antibiotic treatment (day 14 ± 3 days), defined by apyrexia AND no abdominal pain AND no feeding problem: medical visit.
  • Recurrent infection (including AP relapse or reinfection) within 90 days after the beginning of therapy (day 90 ± 15 days): phone call
  • Colonization with antimicrobial resistant Enterobacteriaceae in the gastrointestinal tract at days of randomization and 14.
  • Alpha-diversity measured by Shannon’s index at inclusion, randomization, , 14 and 45.

研究者

申办方类型
Hospital/Clinic/Other health care facility
责任方
Principal Investigator
主要研究者

Dr Jean GASCHIGNARD

Scientific

Assistance Publique Hopitaux De Paris

研究点 (1)

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