Metronidazole Pharmacokinetics (PK) in Premature Infants (PTN_METRO)
Safety and Pharmacokinetics of Multiple Dose Metronidazole in Premature Infants
Yearly in the United States over 500,000 newborns are delivered prematurely. This population is at high risk of catastrophic bowel disease known as necrotizing enterocolitis. Infants with necrotizing enterocolitis are at high risk of death, and survivors are at increased risk of mental retardation. Metronidazole is an antibiotic that is often administered to infants with suspected or confirmed necrotizing enterocolitis. Unfortunately, the appropriate dose of metronidazole in premature infants has not been established and it is likely to be different from older children and adults.
The investigators will investigate the appropriate metronidazole dose in very premature infants by: 1) determining how premature infants eliminate metronidazole from the body and 2) determining the safest and most effective dose of metronidazole in premature infants.
The investigators hypothesis are: 1) The rate of removal of metronidazole will increase with infant maturity and 2) an appropriate metronidazole dosing regimen will result in necessary drug levels to treat bacteria involved in necrotizing enterocolitis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
California
-
Orange, California, United States, 92868
- CHOC Children's
-
-
Kansas
-
Wichita, Kansas, United States, 67214
- Wesely Medical Center
-
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North Carolina
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Durham, North Carolina, United States, 27715
- Duke University
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Gestational age <32 weeks at the time of enrollment.
- Postnatal age <91 days at the time of enrollment.
- Sufficient venous access to permit administration of study medication.
- Infant suspected to have a serious infection and from whom a blood culture has been obtained within 96 hours of study entry.
Exclusion Criteria:
- History of anaphylaxis to metronidazole or other nitroimidazole derivatives (e.g., tinidazole).
- Previous exposure to metronidazole in the week prior to study.
- Previous participation in the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Treatment
Intravenous metronidazole loading dose 15 mg/kg followed by 7.5 mg/kg every 12-24 hours
|
Metronidazole will be administered intravenously to premature infants as a 15 mg/kg loading dose followed by maintenance doses of 7.5 mg/kg every 12 hours for infants with >=14 postnatal days and every 24 hours for infants <14 postnatal days.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Area Under the Curve at Steady State
Time Frame: pre-dose: 30 min; post-dose:10 min, 3-4,6-8, 12-13, 24-25, 36-37, 48-49, 72-73 hours post dose
|
Area under the curve at steady state (AUCss)
|
pre-dose: 30 min; post-dose:10 min, 3-4,6-8, 12-13, 24-25, 36-37, 48-49, 72-73 hours post dose
|
|
Loading Dose Maximum Concentration
Time Frame: 2-5 days of study drug administration
|
Loading Dose Maximum concentration (Cmax)
|
2-5 days of study drug administration
|
|
Loading Dose Minimum Concentration
Time Frame: 2-5 days of study drug administration
|
Loading Dose Minimum Concentration (mg/L)
|
2-5 days of study drug administration
|
|
Multiple Dose Maximum Concentration
Time Frame: 2-5 days of study drug administration
|
Multiple Dose Maximum Concentration (mg/L)
|
2-5 days of study drug administration
|
|
Multiple Dose Minimum Concentration
Time Frame: 2-5 days of study drug administration
|
Multiple Dose Minimum Concentration (mg/L)
|
2-5 days of study drug administration
|
|
Clearance
Time Frame: 2-5 days of study drug administration
|
Clearance (L/h/kg)
|
2-5 days of study drug administration
|
|
Volume of Distribution
Time Frame: 2-5 days of study drug administration
|
Volume of Distribution (L/kg)
|
2-5 days of study drug administration
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
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
- Digestive System Diseases
- Pathologic Processes
- Infections
- Systemic Inflammatory Response Syndrome
- Inflammation
- Gastrointestinal Diseases
- Gastroenteritis
- Intestinal Diseases
- Pregnancy Complications
- Obstetric Labor Complications
- Obstetric Labor, Premature
- Sepsis
- Premature Birth
- Enterocolitis
- Enterocolitis, Necrotizing
- Anti-Infective Agents
- Anti-Bacterial Agents
- Antiprotozoal Agents
- Antiparasitic Agents
- Metronidazole
Other Study ID Numbers
Other Study ID Numbers
- Pro00024571
- HHSN27500003I (OTHER_GRANT: NICHD)
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