- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00718705
Reduction of Spontaneous Prematurity by Antibiotic Treatment (Josamycin) (PREMYC)
Reduction of Spontaneous Prematurity: Impact of Antibiotic Treatment (Josamycin) in Case of Positive PCR for Ureaplasma Spp and/or Mycoplasma Hominis in Amniotic Fluid
Study Overview
Detailed Description
Infection would be the cause of 40 % of spontaneous premature deliveries. The physiopathological hypothesis accepted is a premature ascent of present bacteria in the low genital ways towards the decidual, the foetal membranes then the amniotic liquid. These bacteria are responsible for an inflammatory reaction to the interface feto-maternal characterized by the production of proinflammatory cytokines and pro-contractants agents (prostaglandins, oxytocin) by the decidual and the membranes.
These mediators cause uterine contractions, a maturation of the uterine collar, a rupture of the membranes then a premature birth.
Several recent publications show on the one hand that Mycoplasma hominis and Ureaplasma spp. are the bacteria most frequently found in the amniotic liquid in the second quarter of the pregnancy and that a positive PCR for these bacteria is associated with a premature birth.
A probable assumption would be that Mycoplasma hominis or Ureaplasma spp. cause a premature birth by infecting the fetal membranes and the decidual, then activating the immune system and the pro-inflammatory production of cytokines. These bacteria are sensitive to antibiotic treatment.
Nevertheless, no randomized controlled trials have been carried out to determine wether an antibiotic treatment would decrease spontaneous prematurity in the case of positive PCR in the amniotic liquid.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
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Creteil, France, 94
- Groupe Hospitalier Chenevier-Mondor, CHI
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient older ≥ 18 years
- French speaking
- Women who have an amniocentesis between 15 and 20 weeks of amenorrhoea for an antenatal diagnosis
- Affiliated to social security or an equivalent system
- Karyotype analysis and ultrasound morphological normal (apart from minor signs of trisomy 21)
- Clear amniotic fluid (not contaminated by the mother's blood)
- Gestational age is between 15 WA(day+0) and 20 WA(day+6)
- Patient have not allergy to macrolides
- Do not have cure underway by macrolide
- Patient followed during her pregnancy in an investigator site
- Informed consent and signed
Exclusion Criteria:
- No speaking french
- Having an allergy to macrolides
- Having a multiple pregnancy
- Morphological Anomaly
- Patient no consented
- Lactose Intolerance
- Not agreed to participate
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: 2
Placebo
|
Placebo with posology of 2 grams per day by oral way during 10 days
|
Experimental: 1
josamycin
|
josamycin with posology of 2 grams per day by oral way during 10 days
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Premature birth
Time Frame: between 22 and 37 completed weeks of pregnancy.
|
between 22 and 37 completed weeks of pregnancy.
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Antenatal :occurence of a miscarriage late
Time Frame: between 16 and 22 weeks of amenorrhoea
|
between 16 and 22 weeks of amenorrhoea
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Antenatal : premature delivery
Time Frame: at week of amenorrhea <= 34, 32, 28
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at week of amenorrhea <= 34, 32, 28
|
Antenatal : hospitalisation for risk of premature delivery
Time Frame: antenatal period
|
antenatal period
|
antenatal : Number of day of hospitalisation for risk of premature delivery
Time Frame: antenatal period
|
antenatal period
|
Antenatal : premature rupture of membranes
Time Frame: before 37 week of amenorrhea
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before 37 week of amenorrhea
|
Antenatal : occurence of chorioamnionitis defined by 2 of the following criteria :maternal temperature > 38°C, uterine contractions, Fetid leucorrhoeas, foetal tachycardia > 160bpm, C reactive protein >10mg/l
Time Frame: antenatal period
|
antenatal period
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During childbirth : Hyperthermia > 38°C
Time Frame: Childbirth period
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Childbirth period
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During childbirth : fetal tachycardia > 160 bpm
Time Frame: childbirth period
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childbirth period
|
Post-partum : Hyperthermia > 38°C for more than 24hours
Time Frame: post partum period
|
post partum period
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Post partum :need an antibiotic treatment for more than 48 hours
Time Frame: post partum period
|
post partum period
|
Neonatal : neonatal mortality late
Time Frame: from day 7 to day 28
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from day 7 to day 28
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Neonatal : early neonatal mortality
Time Frame: from day 0 to day 6
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from day 0 to day 6
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Neonatal morbidity : immediate neonatal state
Time Frame: neonatal period
|
neonatal period
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Neonatal morbidity : infection
Time Frame: neonatal period
|
neonatal period
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Neonatal morbidity : respiratory disease
Time Frame: neonatal period
|
neonatal period
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Neonatal morbidity : digestive disease
Time Frame: neonatal period
|
neonatal period
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Gilles KAYEM, Assistance Publique - Hôpitaux de Paris
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
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
- P060216
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.
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