Azithromycin as a Quorum-Sensing Inhibitor for the Prevention of Pseudomonas Aeruginosa Ventilator-Associated Pneumonia
Proof of Concept Study to Investigate the Impact of Azithromycin Administered iv Versus Placebo on the Prevention of Pneumonia in Ventilated Patients Colonized by Pseudomonas Aeruginosa
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
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Liège, Belgium, B-4000
- General Intensive Car Unit, Centre Hospitalier Universitaire de Liège
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Louvain
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Ottignies, Louvain, Belgium, 1340
- Intensive Care Unit, Clinique Saint-Pierre
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-
-
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Belgrade, Former Serbia and Montenegro
- Surgical Intensive Care Unit, Clinical Center of Serbia, Institut of Neurosurgery
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Belgrade, Former Serbia and Montenegro
- Surgical Intensive Care Unit, Clinical Center of Serbia
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-
-
-
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Besancon, France, 25030
- Intensive Care Unit, Jean Minjoz University Hospital
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Lille, France, 59037
- Intensive Car Unit, Calmette University Hospital of Lille
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Limoges, France, 8700
- Medical-surgical intensive car unit, Dupuytren Teaching Hospital
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Montauban, France, 82013
- General Intensive Care Unit, Montauban City Hospital
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Paris, France, 75018
- Medical Intensive Car Unit, Hospital Bichat
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Paris, France, 75018
- Surgical Intensive Car Unit; University Hospital Bichat
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Paris, France, 75674
- General Intensive Care Unit, Hospital Saint-Joseph
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Paris, France, 75679
- Medical Intensive Care Unit, Cochin Hospital
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-
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Krakow, Poland
- Intensive Care Unit, Wojewodzki Hospital
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Sosnowiec, Poland
- Intensive Care Unit, Wojewodzki Hospital
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Warsaw, Poland
- Intensive Care Unit, Central Hospital
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-
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-
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Barcelona, Spain, 08003
- Intensive Care Unit, Hospital del Mar
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Barcelona, Spain, 08035
- Internal Medicine, Vall d'Hebron Hospital
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Palma de Mallorca, Spain, 07014
- Intensive Care Unit, San Dureta University Hospital
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Tarragona, Spain, 43007
- Intensive Care Unit, Joan XXIII University Hospital
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Vaud
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Lausanne, Vaud, Switzerland
- Surgical and Medical Intensive Care Units, University Hospital Lausanne
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male and non pregnant female aged 18 to 75 years
- Patients hospitalized in ICU, under mechanically assisted ventilation expected to be mandatory for 3 days or more
- Reasonable survival chance within next few days with an Apache score 10-25
- Tracheal aspirate found positive for P. aeruginosa
- The subject (or a close family member in case of incompetence) understands the procedure, agrees to participate, and is willing to give written informed consent
- Informed consent must be obtained for all subjects before enrollment in the study, by patient or by a close family member
Exclusion Criteria:
- Poor prognosis as judged by Apache score II score >25
- Pregnant female
- Grossly under-or overweight (BMI<18or >29)
- Ongoing therapy with a macrolide
- Known allergy to any macrolide
- Proven P. aeruginosa pneumonia
- Ongoing anti-pseudomonal therapy with a proven susceptible colonizing strain
- Anticipated short duration of mechanical ventilation (<3 days)
- Known drug interaction that could either decrease efficacy or raise safety concerns
- Severe hepatic failure (type C, score >10 on Child Pugh scale)
- Sick sinus syndrome or long QT syndrome
- Recent donation of blood or participation in another clinical trial within 3 months
- Any situation exposing the patient to higher risk or possibly confounding results
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: 2
Placebo
|
once per day, IV from day 1 to 20
|
|
Experimental: 1
azithromycin iv 300 mg/day
|
300 mg/day, IV from day 1 to 20
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Occurrence of and time to Pseudomonas aeruginosa pneumonia
Time Frame: daily
|
daily
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
occurrence of and time to death
Time Frame: daily
|
daily
|
|
time to extubation
Time Frame: daily
|
daily
|
|
overall outcome
Time Frame: daily
|
daily
|
|
duration of hospitalization and ICU stay
Time Frame: daily
|
daily
|
|
occurrence of infections to other bacterial strains
Time Frame: daily
|
daily
|
|
cost assessment
Time Frame: daily
|
daily
|
|
demonstrate using in vitro and in vivo parameters that azithromycin can be used as a quorum-sensing blocker against P. aeruginosa
Time Frame: daily
|
daily
|
|
determine whether prolonged treatment with azithromycin may induce resistance to any of 11 anti-pseudomonal antibiotics
Time Frame: daily
|
daily
|
|
determine whether P. aeruginosa can develop resistance to the quorum-sensing effect of azithromycin
Time Frame: daily
|
daily
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Christian Van Delden, MD, Service of Infectious Diseases, University Hospital Geneva, Switzerland
- Study Chair: Jean Carlet, MD, General Intensive Care Unit, Hospital Saint-Joseph, Paris, France
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Lung Diseases
- Disease Attributes
- Gram-Negative Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Cross Infection
- Iatrogenic Disease
- Healthcare-Associated Pneumonia
- Pneumonia
- Pneumonia, Ventilator-Associated
- Pseudomonas Infections
- Anti-Infective Agents
- Anti-Bacterial Agents
- Azithromycin
Other Study ID Numbers
Other Study ID Numbers
- Anb006#2001
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