Colistimethate Sodium for Injection in The Treatment of Carbapenem-Resistant Enterobacteriaceae Infection a Prospective, Open-label, Randomized Controlled, Multicenter Clinical Trial
Led by Southeast University, China · Updated on 2025-05-18
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Participants Needed
15
Research Sites
N/A
Total Duration
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What this Trial Is About
Researchers are evaluating the use of colistin in treating infections caused by carbapenem-resistant enterobacteriaceae (CRE), specifically in patients with hospital-acquired pneumonia (HAP) or bloodstream infections in China. This study compares the effectiveness and safety of treatments with and without colistin to understand how well colistin works and its safety profile in these serious infections. The study follows good clinical practice and ethical guidelines, recruiting patients from 14 centers in China.
Patients will be randomly assigned to one of two groups. One group will receive colistin-based therapy combined with other antibiotics such as meropenem, tigecycline, or amikacin. The colistin dose starts with a loading dose followed by maintenance doses given intravenously twice daily. The other group will receive the best available treatment without colistin, including combinations of antibiotics like ceftazidime-avibactam, tigecycline, meropenem, imipenem, or amikacin. Treatment duration and doses are specified for each drug.
Participants will be monitored for outcomes including 14-day all-cause mortality, clinical cure rates, infection clearance, ICU-free days, and adverse events during and after treatment. The study includes follow-up assessments up to 90 days post-randomization to evaluate hospital and ICU mortality. Safety and efficacy will be measured through clinical evaluations, microbiological tests, and adverse event tracking. The total participation time varies depending on follow-up duration and clinical course.
CONDITIONS
Brief Title
Efficacy and Safety of Colistimethate Sodium for Injection in The Treatment of Carbapenem-Resistant Enterobacteriaceae Infection
Who Can Participate
Age: 18Years - 85Years
All Genders
Eligibility Criteria
You may qualify if you...
Patients who can provide written informed consent or whose legal guardian can provide consent
Patients who are hospitalized
Adults aged 18 to 85 years
Suspected or diagnosed hospital-acquired pneumonia or bloodstream infection caused by carbapenem-resistant enterobacteriaceae based on culture or rapid diagnostic tests
Respiratory or blood specimen obtained for culture within 5 days prior to randomization after symptom onset
Patients with APACHE II score between 10 and 30
Hospital-acquired pneumonia patients must have fever or hypothermia, abnormal white blood cell counts, and at least two respiratory symptoms or signs
Bloodstream infection patients must have fever, chills, or hypotension with CRE isolated from two blood cultures
You will not qualify if you...
Patients who received polymyxin for more than 48 hours in the 72 hours before randomization
Patients who received antibiotics for more than 24 hours in the 72 hours before randomization and showed improvement
History of serious allergy or hypersensitivity to colistimethate sodium or its ingredients
Active concurrent pneumonia caused by specified pathogens requiring additional antimicrobials
Diagnosis of primary lung cancer, lung metastases, or known post obstructive pneumonia
Hematological malignancies such as leukemia, lymphoma, or multiple myeloma
History of lung, heart, or stem cell transplantation
Immunocompromised patients at risk of opportunistic infections, including HIV with low CD4 count, recent chemoradiotherapy, high-dose corticosteroids, or severe neutropenia
Chronic liver failure or acute hepatic failure
Participation in other clinical trials within three months
Pregnant or breastfeeding women
Previous enrollment in this study
Conditions affecting trial participation or deemed unsuitable by researchers
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Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - 14 days from randomization
Participants receive treatment with or without colistin to treat carbapenem-resistant Enterobacteriaceae infection. Treatment includes intravenous medications such as colistin combined with other antibiotics or best available therapy without colistin.
Daily treatment visits during 14 days
Follow-up
Duration - Up to 90 days after randomization
Participants are monitored for safety and outcomes including mortality, clinical cure, and adverse events up to 90 days after randomization.
Visits up to 90 days post-treatment for outcome assessments
Trial Site Locations
Total: 15 locations
1
Anhui Provincial People's Hospital
Hefei, Anhui, China, 230000
Actively Recruiting
2
The First Hospital of Anhui Medical University
Hefei, Anhui, China, 230000
Actively Recruiting
3
Jinjiang Municipal Hospitall
Jinjiang, Fujian, China, 362200
Actively Recruiting
4
Huai'an First People's Hospital
Huai'an, Jiangsu, China, 223000
Actively Recruiting
5
The First Hospital of Lianyungang
Lianyungang, Jiangsu, China, 222000
Actively Recruiting
6
Zhongda Hospital Affiliated to Southeast University
Nanjing, Jiangsu, China, 210000
Actively Recruiting
7
Affiliated Hospital of Nantong University
Nantong, Jiangsu, China, 226000
Actively Recruiting
8
Suzhou Municipal Hospitial
Suzhou, Jiangsu, China, 215000
Actively Recruiting
9
The First Affiliated Hospital of Soochow University
Multicentre open-label randomised controlled trial comparing the efficacy and safety of colistin-based combination therapy with the best available therapy for treating hospital-acquired pneumonia or bloodstream infections caused by carbapenem-resistant Enterobacteriaceae (COUNT-CRE): a study protocol.