Actively Recruiting

Phase 3
Age: 18Years +
All Genders
NCT05699174

PO vs IV Antibiotics for the Treatment of Infected Nonunion of Fractures After Fixation

Led by Major Extremity Trauma Research Consortium · Updated on 2026-02-02

250

Participants Needed

13

Research Sites

226 weeks

Total Duration

On this page

Sponsors

M

Major Extremity Trauma Research Consortium

Lead Sponsor

U

United States Department of Defense

Collaborating Sponsor

AI-Summary

What this Trial Is About

This is a Phase III clinical randomized control trial to investigate differences between patient with an infected nonunion treated by PO vs. IV antibiotics. The study population will be 250 patients, 18 years or older, being treated for infected nonunion after internal fixation of a fracture with a segmental defect less than one centimeter. Patients will be randomly assigned to either the treatment (group 1) PO antibiotics for 6 weeks or the control group (group 2) IV antibiotics for 6 weeks. The primary hypothesis is that the effectiveness of oral antibiotic therapy is equivalent to traditional intravenous antibiotic therapy for the treatment of infected nonunion after fracture internal fixation, when such therapy is combined with appropriate surgical management. Clinical effectiveness will be measured as the primary outcome as the number of secondary re-admissions related to injury and secondary outcomes of treatment failure (re-infection, nonunion, antibiotic complications) within the first one year of follow-up, as defined by specified criteria and determined by a blinded data assessment panel. In addition, treatment compliance, the cost of treatment, the number of surgeries required, the type and incidence of complications, and the duration of hospitalization will be measured.

CONDITIONS

Official Title

PO vs IV Antibiotics for the Treatment of Infected Nonunion of Fractures After Fixation

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 18 years or older
  • Nonunion of a fracture previously treated with fixation, defined as unplanned surgery to promote healing more than 3 months after last fixation
  • Infection diagnosed by fracture-related infection (FRI) criteria or CDC criteria, including possible culture-negative infection as determined by the surgeon
  • Scheduled for at least 6 weeks of systemic antibiotic treatment
Not Eligible

You will not qualify if you...

  • High risk of amputation as determined by the initial physician
  • Participation in other investigational therapy within 1 month before or planned within 12 months after infection treatment
  • Being incarcerated or institutionalized
  • Unable to attend required follow-up visits or having medical conditions preventing general anesthesia
  • Prior chronic infection at the fracture site before fixation
  • Pathological fractures caused by cancer
  • History of Paget's Disease
  • Unwillingness or inability to provide consent
  • Inability to complete at least 12 months of follow-up after infection treatment

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Trial Site Locations

Total: 13 locations

1

Indiana University

Indianapolis, Indiana, United States, 46202

Actively Recruiting

2

University of Maryland , MD Department of Orthopaedics

Baltimore, Maryland, United States, 21201

Actively Recruiting

3

Sinai Hospital Baltimore

Baltimore, Maryland, United States, 21215

Not Yet Recruiting

4

Hennepin Health

Minneapolis, Minnesota, United States, 55487

Actively Recruiting

5

Jamaica Hospital Medical Center

Queens, New York, United States, 11418

Not Yet Recruiting

6

Atrium Health, Carolinas Medical Center

Charlotte, North Carolina, United States, 28207

Not Yet Recruiting

7

Wake Forest University Baptist Medical Center

Winston-Salem, North Carolina, United States, 27106

Actively Recruiting

8

University of Okalahoma College of Medicine

Oklahoma City, Oklahoma, United States, 73104

Not Yet Recruiting

9

Penn State University M.S. Hershey Medical Center

Hershey, Pennsylvania, United States, 17033

Actively Recruiting

10

Vanderbilt Medical Center

Nashville, Tennessee, United States, 37203

Actively Recruiting

11

University of Texas Health Science Center at Houston

Houston, Texas, United States, 77030

Not Yet Recruiting

12

University of Washington Harborview Medical Center

Seattle, Washington, United States, 98195

Actively Recruiting

13

University of Wisconsin

Madison, Wisconsin, United States, 53705

Actively Recruiting

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Research Team

W

William Obremskey, MD

CONTACT

K

Karen Trochez

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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