- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05205993
Εffectiveness of Intrauterine Antibiotic Administration for Treatment of Chronic Endometritis
Investigating the Effectiveness of Innovative Intrauterine Antibiotic Therapy for the Treatment of Patients With Chronic Endometritis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
An infectious endometrial environment caused by certain pathologies could compromise establishment of the initial interaction between the embryo and the endometrium. Chronic endometritis (CE) is a case of a persistent endometrial inflammation caused by infectious agents namely Escherichia Coli, Enterococcus faecalis, Streptococcus agalactiae, Mycoplasma, Ureaplasma, and Chlamydia. The perplexity of managing CE is attributed to its asymptomatic nature rendering a definitive diagnosis rather challenging. The list of potential symptoms is limited and vague while manifestation of the disease may be mild and may not correspond to severity. Symptoms include pain in the pelvic cavity, dispareunia, uterine bleeding, vaginal infections and cystitis, and mild gastro-intestinal discomfort. CE is described as a chronic disorder due to its long duration and persistent nature, with potentially slow progression and complex causality, severely compromising reproductive potential of patients.
The antibiotic treatments are primarily administered orally and endometrial re-examination is performed following treatment. It should be emphasized that apart from the differences in the types of antibiotics included, there are also significant discrepancies regarding the dosage of each antibiotic and the different schemes suggested by each practice. Following the antibiotic regime, endometrial receptivity is anticipated to improve. However, a significant correlation between the antibiotic therapeutic approach and a positive results in IVF has failed to be established in literature, indicating that oral antibiotic administration is unseccessful in improving IVF outcome.
A pilot study published by the investigators indicated that combination of intrauterine infusion of antibiotics and oral administration can be more effective in treating CE than solely oral administration. However, it has not been evaluated if sole intrauterine infusion of antibiotics can be of similar effectiveness when compared to the combined regime including intrauterine infusion and oral andministration, or when compared to the gold standard treatment including only oral administration of antibiotics.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Konstantinos Sfakianoudis, MD
- Phone Number: 2106894326
- Email: sfakianosc@yahoo.gr
Study Locations
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Athens, Greece, 15232
- Recruiting
- Genesis AC
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Contact:
- Panagiotis Tzonis, MD
- Phone Number: 6937115569
- Email: ptzonis@gmail.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Positive diagnosis of CE following hysteroscopy and endometrial biopsy (positive diagnosis is required by both evaluations)
- Signed Informed Consent
- 18.5 < BMI < 30
Exclusion Criteria:
- Diagnosed endometriosis or other related Pelvic Inflammatory Disorder (PID)
- Current or previous cancer diagnosis
- Auto-immune or genetic disorders
- Menstrual cycle disorders
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intrauterine infusion of antibiotics
Thirty women will receive only intrauterine infusion of antibiotics for 30 days.
|
A total of 10 intrauterine infusions of 3ml of ciprofloxacin at a concentration of 200 mg/100 ml
|
Experimental: Combination of intrauterine infusion and oral administration of antibiotics
Thirty women will receive a combination of intrauterine infusion and oral administration of antibiotics for 30 days.
|
A total of 10 intrauterine infusions of 3ml of ciprofloxacin at a concentration of 200 mg/100 ml
per os antibiotic administration as the standard line of strategy for treating CE of doxycycline at a dosage of 100mg twice a day and metronidazole of 500mg twice a day for a total of 30 days
|
Active Comparator: Oral administration of antibiotics
Thirty women will receive only oral administration of antibiotics for 30 days.
|
per os antibiotic administration as the standard line of strategy for treating CE of doxycycline at a dosage of 100mg twice a day and metronidazole of 500mg twice a day for a total of 30 days
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Negative diagnosis of CE following hysteroscopy and endometrial biopsy
Time Frame: Negative diagnosis of CE will be assessed in one month -immidiately after treatment completion-.
|
All participants will be subjected to hysteroscopy and endometrial biopsy following completion of treatment.
Regarding hysteroscopy the presence of endometritis will be evaluated according to the published unified diagnostic criteria for CE.
The endometrial biopsy will be performed employing a pipelle.
To minimize contamination risk, following the placement of a vaginal speculum and cleaning external uterine ostium with an iodine solution, the pipelle will be inserted under visual control into the uterine cavity ensuring avoidance of any contact with vaginal walls.
Endometrial samples will be diluted into 2 ml of saline for histological analysis.
For histological analysis the endometrium samples will be fixated employing neutral formalin and paraffin.
To stain the microsections, hematoxyline and eosin will be engaged.
CD138 staining will be performed and positivity will indicate a CE diagnosis (>1 plasma cell per 10HPFs).
A negative CE diagnosis should be confirmed by both assessments
|
Negative diagnosis of CE will be assessed in one month -immidiately after treatment completion-.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of participants with treatment-related adverse events as assessed by CTCAE v6.0
Time Frame: Side-effects will be monitored for one month from treatment initiation which is until completion of treatment
|
Number of reports of side-effects according to CTCAE v6.0 per treated patients
|
Side-effects will be monitored for one month from treatment initiation which is until completion of treatment
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Konstantinos Sfakianoudis, MD, Genesis Athens Clinic
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IAI-1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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