- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05647993
Comparing of Cefazolin Plus Azithromycin Versus Cefazolin in Prevention of Febrile Morbidity After Emergency Cesarean Delivery
January 24, 2024 updated by: Rajavithi Hospital
Comparing of Cefazolin Plus Azithromycin Versus Cefazolin Alone in Prevention of Febrile Morbidity After Emergency Cesarean Delivery: A Randomized Controlled Trial
Cesarean section is the common surgery in world wide.
But the complication like febrile morbidity such as surgical site infection, fever, urinary tract infection and endometritis can be occurred even giving the standard antibiotics.
Therefore if wider bacterial spectrum coverage antibiotic like azithromycin is added to the standard antimicrobial prophylaxis(1st generation cephalosporin), the incidence of febrile morbidity could be reduced.
We will compare the regimen of cefazolin plus azithromycin and standard regimen of cefazolin alone in prevention of febrile morbidity after emergency cesarean section.
Study Overview
Status
Completed
Intervention / Treatment
Detailed Description
This study was designed to evaluate the effect of azithromycin on the incidence of febrile morbidity after the emergency cesarean section.
The standard antimicrobial prophylaxis which is recommended by the ACOG is the 1st generation cephalosporin intravenously only but some of the bacteria that can cause the febrile morbidity after cesarean section wouldn't be killed by the 1st generation cephalosporin.
The antibiotic that can cover them is macrolide group antibiotic such as azithromycin.
Therefore this study will compare the regimen of standard antimicrobial prophylaxis and the regimen of standard antimicrobial prophylaxis with azithromycin intravenously in preventing the febrile morbidity after emergency cesarean section.
Control group will receive the 1st generation cephalosporin intravenously and the intervention group will receive the 1st generation cephalosporin with azithromycin 500mg intravenously.
Primary outcome is febrile morbidity which assessed at postoperative day 3.
The definition of the febrile morbidity in this study is including surgical site infection, endometritis, urinary tract infection and fever alone.
Secondary outcomes are febrile morbidity at postoperative day 7 and day30, neonatal outcome and adverse effect from azithromycin use.
Study Type
Interventional
Enrollment (Actual)
172
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Bangkok, Thailand, 10400
- Rajavithi Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Singleton pregnancy with a gestation of 24 weeks or more
- Undergoing non-elective cesarean delivery during labor or rupture of membrane more than 4 hr
- No allergy to macrolide such as azithromycin and clindamycin
- Provide informed consent
- Partner of participant allows the patient to participate the research
Exclusion Criteria:
- Use of azithromycin within 7 days before enrollment
- Chorioamnionitis or other infection requiring postpartum antibiotic therapy (except for antibiotics for group B streptococcus)
- Liver disease (Cirrhosis or AST more than 3 times the upper normal limit)
- Serum creatinine level of more than 2.0 mg/dL or need dialysis
- Diarrhea at the time of enrollment
- Maternal heart disease
- Use of medication known to prolonged the QT interval
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Control group (Placebo)
Patient will receive standard antimicrobial prophylaxis(cefazolin intravenously weight dependent) and placebo(0.9%
NaCl 100 ml intravenously) before the incision
|
All the participants will receive the cefazolin intravenously.
The dosage of the cefazolin is depend on participant's weight.
The participant with weight less than 80kg will receive cefazolin 1 gm and between 80-120kg will receive cefazolin 2 gm and for the participant with more than 120kg will receive cefazolin 3 gm before the incision.
Other Names:
For the placebo group will receive the cefazolin intravenously and 0.9% NaCl 100ml before the incision
Other Names:
|
Experimental: azithromycin
Patient will receive standard antimicrobial prophylaxis(cefazolin intravenously weight dependent) and azithromycin 500 mg intravenously before the incision
|
All the participants will receive the cefazolin intravenously.
The dosage of the cefazolin is depend on participant's weight.
The participant with weight less than 80kg will receive cefazolin 1 gm and between 80-120kg will receive cefazolin 2 gm and for the participant with more than 120kg will receive cefazolin 3 gm before the incision.
Other Names:
Intervention group patient will receive standard antimicrobial prophylaxis(cefazolin intravenously weight dependent) and azithromycin 500 mg intravenously before the incision
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of febrile morbidity at postoperative day 3
Time Frame: postoperative day 3
|
Patient will be assessed at postoperative day 3. Febrile morbidity is including surgical site infection, endometritis, urinary tract infection and fever.
There is the questionnaire for the assessor to check if there is the febrile morbidity or not.
(There are criteria diagnosis of febrile morbidity from the CDC in the questionnaire)
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postoperative day 3
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
adverse drug effect
Time Frame: baseline and postoperative day 3, 7 and 30
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Any adverse drug effect of azithromycin such as diarrhea, urticaria, and anaphylactic shock
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baseline and postoperative day 3, 7 and 30
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Incidence of adverse Neonatal outcome
Time Frame: baseline and postoperative day 3, 7 and 30
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any adverse neonatal outcome such as NICU admission, neonatal sepsis, need phototherapy, respiratory distress, Apgar score, neonatal death and neonatal enterocolitis (Assessed and diagnosis by pediatric doctor)
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baseline and postoperative day 3, 7 and 30
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Incidence of febrile morbidity at postoperative day 7 and day 30
Time Frame: postoperative day 7 and day 30
|
Patient will be assessed at postoperative day 7 and day 30.
Febrile morbidity is including surgical site infection, endometritis, urinary tract infection and fever.
There is the questionnaire for the assessor to check if there is the febrile morbidity or not.
(There are criteria diagnosis of febrile morbidity from the CDC in the questionnaire)
|
postoperative day 7 and day 30
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
December 14, 2022
Primary Completion (Actual)
November 30, 2023
Study Completion (Actual)
December 30, 2023
Study Registration Dates
First Submitted
November 4, 2022
First Submitted That Met QC Criteria
December 8, 2022
First Posted (Actual)
December 13, 2022
Study Record Updates
Last Update Posted (Estimated)
January 25, 2024
Last Update Submitted That Met QC Criteria
January 24, 2024
Last Verified
February 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 65094
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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