- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00000585
Penicillin Prophylaxis in Sickle Cell Disease (PROPS)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
BACKGROUND:
For over 20 years children with sickle cell anemia have been known to have an increased susceptibility to severe bacterial infection, particularly due to Streptococcus pneumoniae. Meningitis, pneumonia and septicemia due to this organism have been recognized as the major causes of death for these children, with children under three years of age being at highest risk. The annual incidence of pneumococcal septicemia among young children with sickle cell anemia appears to have remained remarkably constant over the last two decades at approximately 10 percent. This illness can often be fulminant, progressing from the onset of fever to death in less than 12 hours, with a case fatality rate ranging as high as 35 percent.
Penicillin prophylaxis has been advocated as a preventive measure against severe pneumococcal infections in children with sickle cell anemia. One study had shown that the risk of pneumococcal infection in these children could be reduced by the use of parenteral penicillin.
DESIGN NARRATIVE:
Phase I was a multi-center, randomized, double-blind, placebo-controlled trial. One hundred and five patients were assigned to the penicillin group and 110 to placebo. The primary endpoint was a documented severe infection due to S. pneumoniae. The secondary endpoint was a severe infection due to an organism other than S. pneumoniae.
Because data were not available to define the age at which prophylactic penicillin could be safely discontinued, the NHLBI launched Phase II of the Prophylactic Penicillin Study beginning in 1987. Recruitment ended in August, 1993. The clinical phase of Phase II ended in August, 1994.
Phase II was a multi-center randomized trial to evaluate the hazards of discontinuing daily oral penicillin at the age of five years. Within three months of their fifth birthdays, all children were randomized to continue oral penicillin prophylaxis or to stop prophylaxis. Each child was followed for a minimum of two years. The primary endpoint was a comparison of documented pneumococcal infection in children continuing penicillin after five years of age versus children whose prophylaxis was stopped at five years of age. Ancillary studies conducted in subsets of patients included: the prevalence of colonization of the nasopharynx with antibiotic resistant microorangisms; and the relationship of antibody response to pneumococcal vaccination to the incidence of pneumococcal sepsis in this patient population.
Study Type
Phase
- Phase 3
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Masking: Double
Collaborators and Investigators
Investigators
- David Becton, University of Arkansas
- Ann Bjornson, Gamble Institute of Medical Research
- George Buchanan, University of Texas
- Neil Grossman, Children's Hospital Medical Center, Cincinnati
- C. Holbrook, East Carolina University School of Medicine
- Rathyi Iyer, University of Mississippi Medical Center
- Karen Kalinyak, Children's Hospital Medical Center, Cincinnati
- Thomas Kinney, Duke University
- Helen Maurer, University of Illinois at Chicago
- Scott Miller, New York Health Science Center
- Charles Pegelow, University of Miami
- Sergio Piomelli, Columbia University
- Gregory Reaman, Children's Hospital National Medical Center
- Alan Schwartz, Washington University School of Medicine
- Elliott Vichinsky, Children's Hospital & Medical Center
- Winfred Wang, St. Jude Children's Research Hospital
- Doris Wethers, St. Luke's Roosevelt Institute of Health Science
- Gerald Woods, Children's Mercy Hospital Kansas City
Publications and helpful links
General Publications
- Gaston MH, Verter JI, Woods G, Pegelow C, Kelleher J, Presbury G, Zarkowsky H, Vichinsky E, Iyer R, Lobel JS, et al. Prophylaxis with oral penicillin in children with sickle cell anemia. A randomized trial. N Engl J Med. 1986 Jun 19;314(25):1593-9. doi: 10.1056/NEJM198606193142501.
- Falletta JM, Woods GM, Verter JI, Buchanan GR, Pegelow CH, Iyer RV, Miller ST, Holbrook CT, Kinney TR, Vichinsky E, et al. Discontinuing penicillin prophylaxis in children with sickle cell anemia. Prophylactic Penicillin Study II. J Pediatr. 1995 Nov;127(5):685-90. doi: 10.1016/s0022-3476(95)70154-0.
- Bjornson AB, Falletta JM, Verter JI, Buchanan GR, Miller ST, Pegelow CH, Iyer RV, Johnstone HS, DeBaun MR, Wethers DL, Wang WC, Woods GM, Holbrook CT, Becton DL, Kinney TR, Reaman GH, Kalinyak K, Grossman NJ, Vichinsky E, Reid CD. Serotype-specific immunoglobulin G antibody responses to pneumococcal polysaccharide vaccine in children with sickle cell anemia: effects of continued penicillin prophylaxis. J Pediatr. 1996 Dec;129(6):828-35. doi: 10.1016/s0022-3476(96)70026-4.
- Woods GM, Jorgensen JH, Waclawiw MA, Reid C, Wang W, Pegelow CH, Rogers ZR, Iyer RV, Holbrook CT, Kinney TR, Vichinsky E, DeBaun MR, Grossman NJ, Thomas MD, Falletta JM. Influence of penicillin prophylaxis on antimicrobial resistance in nasopharyngeal S. pneumoniae among children with sickle cell anemia. The Ancillary Nasopharyngeal Culture Study of Prophylactic Penicillin Study II. J Pediatr Hematol Oncol. 1997 Jul-Aug;19(4):327-33. doi: 10.1097/00043426-199707000-00011.
- Gaston MH, Verter J. Sickle cell anaemia trial. Stat Med. 1990 Jan-Feb;9(1-2):45-9; discussion 49-51. doi: 10.1002/sim.4780090111.
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 305
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Pneumonia
-
King Edward Memorial HospitalCompletedNosocomial Pneumonia | Healthcare-Associated Pneumonia | Aspiration Pneumonia | Ventilator-Associated PneumoniaIndia
-
Melinta Therapeutics, Inc.WithdrawnHospital-Acquired Bacterial Pneumonia | Ventilator-Associated Bacterial Pneumonia | Hospital-Acquired Pneumonia | Ventilator-Associated Pneumonia
-
Venatorx Pharmaceuticals, Inc.Department of Health and Human ServicesNot yet recruitingHospital-acquired Pneumonia | Ventilator-associated Pneumonia
-
Hannover Medical SchoolCharite University, Berlin, Germany; University of LeipzigUnknownCOVID-19 | Bacterial Pneumonia | Viral Pneumonia | Pneumonia Due to Streptococcus Pneumoniae | Pneumonia Due to H. Influenzae | Pneumonia, Organism Unspecified | Pneumonia in Diseases Classified Elsewhere | Pneumonia Due to Other Specified Infectious OrganismsGermany
-
Nantes University HospitalSociété Française d'Anesthésie et de RéanimationCompletedPneumonia | Sepsis | Ventilator-Associated Pneumonia | Hospital Acquired PneumoniaFrance
-
University Medical Centre LjubljanaUniversity of Ljubljana, Faculty of MedicineUnknownCommunity Acquired Pneumonia | Ventilator Associated Pneumonia | Hospital Acquired PneumoniaSlovenia
-
PfizerCompletedVentilator-associated Pneumonia (VAP) | Nosocomial Pneumonia (NP)Bulgaria, France, Italy, Korea, Republic of, Mexico, Peru, Poland, Russian Federation, Spain, Turkey, United Kingdom, Vietnam, Philippines, China, Ukraine, Argentina, Brazil, Hungary, Romania, India, Japan, Taiwan, Latvia, Czechia, Slov... and more
-
Arpida AGTerminatedHospital-Acquired Pneumonia | Ventilator-Associated Pneumonia | Health-Care-Associated Pneumonia
-
ShionogiCompletedHospital Acquired Pneumonia (HAP) | Healthcare-associated Pneumonia (HCAP) | Ventilator Associated Pneumonia (VAP)Israel, Spain, United States, Belgium, Canada, Czechia, Estonia, France, Georgia, Germany, Hungary, Japan, Latvia, Philippines, Puerto Rico, Russian Federation, Serbia, Taiwan, Ukraine
-
Methodist Health SystemCompletedHospital-acquired Pneumonia | Ventilator-associated PneumoniaUnited States
Clinical Trials on penicillin
-
Imperial College LondonRecruiting
-
PfizerCompleted
-
KEMRI-Wellcome Trust Collaborative Research ProgramLondon School of Hygiene and Tropical Medicine; University of Oxford; University...Completed
-
Children's Hospital Medical Center, CincinnatiUganda Heart InstituteRecruitingRheumatic Heart DiseaseUganda
-
Jun LiUnknown
-
Peking Union Medical College HospitalUnknown
-
Children's National Research InstituteUniversity of Cape Town; Thrasher Research Fund; Murdoch Childrens Research Institute and other collaboratorsUnknownHeart Diseases | Rheumatic Heart Disease | Rheumatic Heart Disease in Children | Latent Rheumatic Heart DiseaseUganda
-
University of Southern CaliforniaUniversidad Peruana Cayetano Heredia; AIDS Healthcare FoundationRecruiting
-
World Health OrganizationUnknown
-
National Institute of Allergy and Infectious Diseases...Completed