Status:

COMPLETED

A Study to Determine the Efficacy, Safety and Tolerability of Aztreonam-Avibactam (ATM-AVI) ± Metronidazole (MTZ) Versus Meropenem (MER) ± Colistin (COL) for the Treatment of Serious Infections Due to Gram Negative Bacteria.

Lead Sponsor:

Pfizer

Collaborating Sponsors:

Innovative Medicines Initiative

Biomedical Advanced Research and Development Authority

Conditions:

Complicated Intra-abdominal Infection

Hosptial Acquired Pneumonia

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

A Phase 3 comparative study to determine the efficacy, safety and tolerability of Aztreonam-Avibactam (ATM-AVI) ± Metronidazole (MTZ) versus Meropenem (MER) ± Colistin (COL) for the treatment of serio...

Detailed Description

A Phase 3 Prospective, Randomized, Multicenter, Open Label, Central Assessor Blinded, Parallel Group, Comparative Study To Determine The Efficacy, Safety And Tolerability Of Aztreonam-Avibactam (ATM-A...

Eligibility Criteria

Inclusion

  • Inclusion Criteria:
  • All subjects:
  • Male or female from 18 years of age
  • Provision of informed consent
  • Confirmed diagnosis of HAP/VAP or cIAI requiring iv antibiotic treatment
  • Female patients are authorized to participate in this clinical study if criteria concerning pregnancy avoidance stated in the protocol are met and negative pregnancy test
  • Additional for cIAI:
  • Diagnosis of cIAI, EITHER:
  • Intra-operative/postoperative enrolment with visual confirmation of cIAI. OR Preoperative enrollment with evidence of systemic inflammatory response, physical and radiological findings consistent with cIAI; confirmation of cIAI at time of surgery within 24 hours of study entry
  • Surgical intervention within 24 hours (before or after) the administration of the first dose of study drug
  • Additional for HAP/VAP:
  • Onset symptoms \> 48h after admission to or \<7 days after discharge from an inpatient care facility
  • New or worsening infiltrate on CXR or CT scan
  • Clinical signs and symptoms and laboratory findings consistent with HAP/VAP
  • Respiratory specimen obtained for Gram stain and culture following onset of symptoms and prior to randomisation
  • Exclusion criteria:
  • All subjects:
  • APACHE II score \> 30
  • Confirmed or suspected infection caused by Gram-negative species not expected to respond to study drug, or Gram-positive species
  • Receipt of \>24 hr systemic antibiotic within 48h prior to randomisation (exception in case of treatment failure)
  • History of serious allergy, hypersensitivity (eg, anaphylaxis), or any serious reaction to aztreonam, carbapenem,monobactam or other β-lactam antibiotics, avibactam, nitroimidazoles or metronidazole, or any of the excipients of the study drugs
  • Known Clostridium difficle associated diarrhoea
  • Requirement for effective concomitant systemic antibacterials or antifungals
  • Creatinine clearance ≤15 ml/min or requirement or expectation for renal replacement therapy
  • Acute hepatitis, cirrhosis, acute hepatic failure, chronic hepatic failure
  • Hepatic disease as indicated by AST or ALT \>3 × ULN. Patients with AST and/or ALT up to 5 × ULN are eligible if acute and documented by the investigator as being directly related infectious process
  • Patient has a total bilirubin \>2 × ULN, unless isolated hyperbilirubinemia is directly related to infectious process or due to known Gilbert's disease
  • ALP \>3 × ULN. Patients with values \>3 × ULN and \<5 x ULN are eligible if acute and directly related to the infectious process being treated
  • Absolute neutrophil count \<500/mm3
  • Pregnant or breastfeeding or if of child bearing potential, not using a medically accepted effective method of birth control.
  • Any other condition that may confound the results of the study or pose additional risks to the subject
  • Unlikely to comply with protocol
  • History of epilepsy or seizure disorders excluding febrile seizures of childhood
  • Additional for cIAI
  • Diagnosis of abdominal wall abscess; small bowel obstruction or ischemic bowel disease without perforation; traumatic bowel perforation with surgery within 12 hours of diagnosis; perforation of gastroduodenal ulcer with surgery \< 24 hours of diagnosis primary etiology is not likely to be infectious
  • Simple cholecystitis, gangrenous cholecystitis without rupture, simple appendicitis, acute suppurative cholangitis, infected necrotizing pancreatitis, pancreatic abscess
  • Prior liver, pancreas or small-bowel transplant
  • Staged abdominal repair (STAR), open abdomen technique or marsupialisation
  • Additional for HAP/VAP
  • APACHE II score \< 10
  • Known or high likelihood of Gram-positive monomicrobial infection
  • Lung abscess, pleural empyema, post-obstructive pneumonia
  • Lung or heart transplant
  • Myasthenia gravis

Exclusion

    Key Trial Info

    Start Date :

    April 5 2018

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    February 23 2023

    Estimated Enrollment :

    422 Patients enrolled

    Trial Details

    Trial ID

    NCT03329092

    Start Date

    April 5 2018

    End Date

    February 23 2023

    Last Update

    December 10 2024

    Active Locations (157)

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    Page 1 of 40 (157 locations)

    1

    Banner University Medical Center - Tucson

    Tucson, Arizona, United States, 85719

    2

    Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

    Torrance, California, United States, 90502

    3

    Harbor-UCLA Medical Center

    Torrance, California, United States, 90509

    4

    Southern Illinois University School of Medicine

    Springfield, Illinois, United States, 62702