Randomized Open Label Study of Oral Versus Intravenous Antibiotic Treatment for Bone and Joint Infections Requiring Prolonged Antibiotic Treatment: Multi-centre Study
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 1,054
- 试验地点
- 2
- 主要终点
- The Frequency of Definite Failure of Infection Treatment.
研究概览
简要总结
The study will compare the outcomes of treating bone and joint infections with 6 weeks of intravenous antibiotics with 6 weeks of oral antibiotic treatment. The trial is of antibiotic "strategy" rather than of individual antibiotics. The study will be open label, but the primary outcome will be proven failure of infection treatment, determined by pre-established objective criteria for treatment failure. The null hypothesis tested is that there will be no difference in treatment failure rates.
详细描述
A long course of antibiotic therapy given by a "drip" (i.e. intravenous) is recommended treatment for many serious bacterial infections. It is costly and inconvenient for the patient to remain hospitalised for therapy, so outpatient antibiotic therapy (OPAT) programmes have been established in many countries to deliver intravenous antibiotics safely and conveniently. The majority of patients referred to OPAT programmes have bone and joint infections. However, there is no clear evidence that bone and joint infection really require long courses of intravenous antibiotics rather than oral antibiotics.
We will compare the outcome of treatment with intravenous versus oral antibiotic therapy for patients with bone and joint infection. The choice of antibiotic is complex, and antibiotics that are suitable oral choices are often not suitable intravenous choices and vice versa. Subjects will therefore be randomized to an oral or intravenous "strategy," rather than to individual antibiotics. Outcomes will be determined by pre-established objective criteria for treatment failure.
We have conducted a pilot study in one centre (Oxford), recruiting approximately 200 patients, and are now expanding to include multi-centre recruitment in the UK, aiming to recruit 1050 patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Is willing and able to give informed consent for participation in the study. Has a bone and joint infection one of the following categories;
- •Native osteomyelitis.
- •Native joint septic arthritis.
- •Diabetic foot infection with osteomyelitis.
- •Prosthetic joint associated infection.
- •Discitis/ spinal osteomyelitis/ epidural abscess
- •Has had at least 48 hours, but not more than 7 days, of IV antibiotic therapy already given after definitive surgical management.
- •Has a clinical diagnosis of bacterial infection (caused by any organism excepting mycobacteria).
- •Is clinically stable in the opinion of the study clinicians, has no further interventions to treat acute infection required or planned.
排除标准
- •Has Staph aureus bacteraemia.
- •Has suspected bacterial endocarditis.
- •Has suspected mediastinal infection.
- •Has suspected central nervous system infection.
研究组 & 干预措施
Oral antibiotics
干预措施: Antibiotics (Drug)
Intravenous antibiotics
干预措施: Antibiotics (Drug)
结局指标
主要结局
The Frequency of Definite Failure of Infection Treatment.
时间窗: 1 year
Number of participants with definite failure of infection treatment defined by microbiological, histological and clinical criteria and assessed by an independent blinded endpoint committee
次要结局
未报告次要终点
研究者
Matthew Scarborough
Primary Investigator
Oxford University Hospitals NHS Trust