Fosfomycin Plus Imipenem for Treatment of Infective Endocarditis
Evaluation of the Efficacy and Safety of Fosfomycin Plus Imipenem for the Treatment of Methicillin-resistant Staphylococcus Aureus (MRSA) Infective Endocarditis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Madrid, Spain, 28034
- Hospital Ramon y Cajal
-
Madrid, Spain, 28046
- Hospital La Paz
-
Madrid, Spain, 28007
- Hospital Gregorio Marañón
-
Sevilla, Spain, 41013
- Hospital Virgen Del Rocio
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Sevilla, Spain, 410071
- Hospital Virgen Macarena
-
-
Catalonia
-
Barcelona, Catalonia, Spain, 08036
- Hospital Clinic of Barcelona
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Barcelona, Catalonia, Spain, 08025
- Hospital Sant Pau of Barcelona
-
Barcelona, Catalonia, Spain, 08907
- Hospital Bellvitge of Barcelona
-
-
Madrid
-
Alcorcón - Madrid, Madrid, Spain, 28922
- Fundacion Hospital Alcorcon
-
-
Vizcaya
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Bilbao, Vizcaya, Spain, 48903
- Hospital De Cruces
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Suspected methicillin-resistant staphyloccocus aureus infective endocarditis on a native valve, prosthetic valve or pacemakers´s electrode or defibrillators with definitive or probable diagnosis by the modified Duke criteria (Li J, et al. Clin Infect Dis. 2000).
- Patients over 18 years.
Exclusion Criteria:
- Patients who did not sign informed consent.
- Patients with active consumption intravenous drug.
- Patients with emergent surgery criteria (<72 hours).
- Patients or cardiogenic shock.
- Patients with antibiotic active against MRSA over 72 hours or they may need another antibiotic active against MRSA than those in the study.
- Patients with chronic renal failure on hemodialysis who received empirical treatment with vancomycin as a single dose and have a valley ≥ 15 mcg / mL on the third day.
- Patients with MRSA strains resistant to fosfomycin (MIC> 64 mg / L) (<10%) or vancomycin (MIC> 2 mg / L) or with an MIC to vancomycin of 2 mg / L.
- Patients with any formal contraindication to be treated with study drugs
- Patients treated with any investigational drug within 30 days prior to entering the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 1
IV fosfomycin and imipenem adjusted to renal function
|
IV Fosfomycin 2 gr./6 hours and IV Imipenem 1 gr./6 hours adjusted acoording to renal function during 4-8 weeks
|
|
Active Comparator: 2
IV Vancomycin twice a day with valley leves higher than 15 mcg/kg
|
IV Vancomycin 30 mg/kg twice a day with valley leves higher than 15 mcg/kg
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Proportion of patients with negative blood cultures.
Time Frame: 7 days
|
7 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Toxicity due to treatment
Time Frame: 20 weeks
|
20 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Asunción Moreno Camacho, MD, Hospital Clinic of Barcelona
Publications and helpful links
General Publications
- Pericàs JM, Hernández-Meneses M, Muñoz P, Martínez-Sellés M, Álvarez-Uria A, de Alarcón A, Gutiérrez-Carretero E, Goenaga MA, Zarauza MJ, Falces C, Rodríguez-Esteban MÁ, Hidalgo-Tenorio C, Hernández-Cabrera M, Miró JM; Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES). Characteristics and Outcome of Acute Heart Failure in Infective Endocarditis: Focus on Cardiogenic Shock. Clin Infect Dis. 2021 Sep 7;73(5):765-774. doi: 10.1093/cid/ciab098.
- Pericàs JM, Ambrosioni J, Muñoz P, de Alarcón A, Kestler M, Mari-Hualde A, Moreno A, Goenaga MÁ, Fariñas MC, Rodríguez-Álvarez R, Ojeda-Burgos G, Gálvez-Acebal J, Hidalgo-Tenorio C, Noureddine M, Miró JM; GAMES Investigators. Prevalence of Colorectal Neoplasms Among Patients With Enterococcus faecalis Endocarditis in the GAMES Cohort (2008-2017). Mayo Clin Proc. 2021 Jan;96(1):132-146. doi: 10.1016/j.mayocp.2020.06.056.
- Pericas JM, Llopis J, Munoz P, Galvez-Acebal J, Kestler M, Valerio M, Hernandez-Meneses M, Goenaga MA, Cobo-Belaustegui M, Montejo M, Ojeda-Burgos G, Sousa-Regueiro MD, de Alarcon A, Ramos-Martinez A, Miro JM; GAMES Investigators. A Contemporary Picture of Enterococcal Endocarditis. J Am Coll Cardiol. 2020 Feb 11;75(5):482-494. doi: 10.1016/j.jacc.2019.11.047. Erratum In: J Am Coll Cardiol. 2020 Jun 16;75(23):2998-3000.
- del Rio A, Gasch O, Moreno A, Pena C, Cuquet J, Soy D, Mestres CA, Suarez C, Pare JC, Tubau F, Garcia de la Maria C, Marco F, Carratala J, Gatell JM, Gudiol F, Miro JM; FOSIMI Investigators. Efficacy and safety of fosfomycin plus imipenem as rescue therapy for complicated bacteremia and endocarditis due to methicillin-resistant Staphylococcus aureus: a multicenter clinical trial. Clin Infect Dis. 2014 Oct 15;59(8):1105-12. doi: 10.1093/cid/ciu580. Epub 2014 Jul 21.
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 (Actual)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- FOSIMI
- EudraCT number: 2008-008683-28
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