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En undersøgelse for at lære om undersøgelsesmedicinen Aztreonam-Avibactam (ATM-AVI) hos spædbørn og nyfødte indlagt på hospitaler med bakteriel infektion (CHERISH) (CHERISH)

14. oktober 2026 opdateret af: Pfizer

Et fase 2a, 2-delt, åbent, ikke-randomiseret, multicenter, enkelt- og flerdosisforsøg til evaluering af farmakokinetik, sikkerhed og tolerabilitet af Aztreonam og Avibactam ± Metronidazol hos nyfødte og spædbørn fra fødslen til under 9 måneders alderen med Mistænkte eller bekræftede infektioner på grund af gramnegative patogener, der kræver intravenøs antibiotikabehandling

The purpose of this study is to learn about the safety and effects of ATM-AVI for the possible treatment of infections caused by a type of bacteria called gram-negative bacteria.

The study medicine is a combination of an antibiotic, aztreonam (ATM), and another medicine, avibactam (AVI), which is used to help stop bacteria from being resistant to antibiotics. Antibiotics are medicines that fights bacteria and infections.

The study will include newborns and infants up to 9 months of age who are admitted in the hospital.

The study is conducted in 2 parts: Part A and Part B.

In Part A, all participants will receive a single intravenous (injected directly into a vein) infusion of ATM-AVI. This is to study the safety and effects of a single amount.

In Part B, all participants will receive multiple intravenous infusions of ATM-AVI as treatment for a possible or confirmed infection with gram-negative bacteria.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a 2-part Phase 2a, non-randomized, multicenter, open-label, single and multi-dose study to assess pharmacokinetics (PK), safety, and tolerability of ATM-AVI in hospitalized neonates and infants aged birth, including preterm birth, to <9 months. A total of 48 participants will be enrolled in 4 age cohorts of 12 each, 6 Part A and 6 Part B. Part A will begin enrolling before Part B and no infant may participate in both parts. Cohort 1 will include full term infants age ≥13 weeks to <39 weeks and preterm infants postmenstrual age ≥50 weeks to <75 weeks. Cohort 2 will include full term infants age ≥28 weeks to <13 weeks and preterm infants postmenstrual age ≥40 weeks to <50 weeks and ≥28 days of age. Cohort 3 will include full term infants age birth to <28 days. Cohort 4 will include preterm infants age birth to <28 days or postmenstrual age <40 weeks.

Participants in Part A must be hospitalized and receiving intravenous antibiotic treatment for a suspected or confirmed bacterial infection. Participants will receive a single 3 hour intravenous infusion of ATM-AVI and have 3 ATM-AVI blood level assessments during and up to 5 hour after the infusion. Participants will be observed for 48 hours following the infusion to assess safety and toleration and will have a final follow-up safety assessment which may be conducted by telephone 4-5 weeks following the infusion. The single infusion of ATM-AVI is administered to assess the safety, tolerability, and pharmacokinetics of a single dose of ATM-AVI and is not intended as treatment for the bacterial infection. The total duration of study participation in Part A is expected to be 5 weeks through the end of the final safety follow-up.

Participants in Part B must be hospitalized with suspected or confirmed aerobic gram-negative bacterial infection requiring intravenous antibacterial therapy. Part B participants will receive multiple 3 hour intravenous infusions of ATM-AVI every 6 hour (8 hours for preterm infants) for 3-14 days as treatment for their bacterial infection and to assess ATM-AVI pharmacokinetics, safety, tolerability, and efficacy. Participants with complicated intra-abdominal infection (cIAI) will also receive intravenous metronidazole and all participants will have the option to receive other intravenous antibiotic treatment for gram-positive bacteria, as appropriate. Participants who have a good clinical response after 72 hours of intravenous ATM-AVI treatment may be switched to a different orally administered antibiotic, if clinically appropriate. Part B participants will have a total of 5 ATM-AVI blood level assessments over the first 2 or more days following the start of ATM-AVI infusions and will have their clinical response assessed at the End of Treatment (intravenous and oral, if applicable), and at a Test-of-Cure (TOC) evaluation 7 to 14 days after the last antibiotic treatment (intravenous or oral). A final safety assessment which may be conducted by telephone will occur 4-5 weeks after the last dose of ATM-AVI. The total duration of study participation in Part B is expected to be up to 7 weeks through the end of the final safety follow-up.

Additional safety monitoring will be provided by an independent external Data Monitoring Committee (DMC). Enrollment for the study will begin with Part A, single dose, cohorts 1-3. Part A Cohort 4 (preterm neonates) will commence enrollment after sponsor and DMC review of plasma drug levels and safety for a least 2 participants in Part A Cohort 3 and review of ATM-AVI safety and tolerability for all participants enrolled at that time. Enrollment in the multidose Part B cohorts will be delayed until preliminary information is obtained regarding ATM-AVI multidose safety, tolerability, and drug levels for the participants 9 months to 2 years of age in the separate ongoing ATM-AVI pediatric study C3601008 [NCT05639647].

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

48

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Buenos Aires
      • Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, 1039
        • Rekruttering
        • Sanatorio Sagrado Corazón
      • Mar del Plata, Buenos Aires, Argentina, 7600
        • Rekruttering
        • Clinica Del Niño Y La Madre
    • Córdoba Province
      • Córdoba, Córdoba Province, Argentina, X5000IIH
        • Rekruttering
        • Clinica Privada del Sol S.A
    • Tucumán Province
      • San Miguel de Tucumán, Tucumán Province, Argentina, 4000
        • Rekruttering
        • Hospital del Niño Jesús
      • Burgas, Bulgarien, 8000
        • Rekruttering
        • UMHAT Deva Maria
      • Rousse, Bulgarien, 7002
        • Rekruttering
        • Umhat Kanev
    • California
      • Orange, California, Forenede Stater, 92868
        • Rekruttering
        • Children's Hospital of Orange County
      • Orange, California, Forenede Stater, 92868
        • Rekruttering
        • Children's Hospital of Orange County Southwest Tower
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80045
        • Rekruttering
        • Children's Hospital Colorado
    • Indiana
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Rekruttering
        • Riley Hospital for Children at Indiana University Health
    • Kentucky
      • Louisville, Kentucky, Forenede Stater, 40202
        • Rekruttering
        • Norton Children's Hospital
      • Louisville, Kentucky, Forenede Stater, 40202
        • Rekruttering
        • Novak Center for Children's Health
      • Louisville, Kentucky, Forenede Stater, 40202
        • Rekruttering
        • University of Louisville, Norton Children's Research Institute
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02111
        • Rekruttering
        • Tufts Medical Center
    • North Carolina
      • Durham, North Carolina, Forenede Stater, 27710
        • Rekruttering
        • Duke University - Main Hospital and Clinics
    • Texas
      • Houston, Texas, Forenede Stater, 77030
        • Rekruttering
        • The University of Texas Health Science Center at Houston
      • Houston, Texas, Forenede Stater, 77030
        • Rekruttering
        • Memorial Hermann Hospital - Texas Medical Center
    • Kentrikí Makedonía
      • Thessaloniki, Kentrikí Makedonía, Grækenland, 546 42
        • Ikke rekrutterer endnu
        • Ippokrateio General Hospital of Thessaloniki
    • Gujarat
      • Surat, Gujarat, Indien, 395002
        • Rekruttering
        • Nirmal Hospital Pvt Ltd.
    • Karnataka
      • Bengaluru, Karnataka, Indien, 560074
        • Rekruttering
        • RajaRajeswari Medical College and Hospital
    • Maharashtra
      • Pune, Maharashtra, Indien, 411006
        • Rekruttering
        • Sahyadri Super Speciality Hospital
    • Uttar Pradesh
      • Lucknow, Uttar Pradesh, Indien, 226030
        • Rekruttering
        • Medanta Hospital Lucknow
    • West Bengal
      • Kolkata, West Bengal, Indien, 700017
        • Rekruttering
        • Institute of Child Health
    • Central District
      • Petah Tikva, Central District, Israel, 49202
        • Rekruttering
        • Schneider Children's Medical Center
    • Northern District
      • Haifa, Northern District, Israel, 3109601
        • Rekruttering
        • Rambam Health Care Campus
    • Florence
      • Florence, Florence, Italien, 50139
        • Rekruttering
        • Azienda Ospedaliera Universitaria Meyer IRCCS
      • Madrid, Spanien, 28041
        • Ikke rekrutterer endnu
        • Hospital Universitario 12 de Octubre
    • Madrid, Comunidad de
      • Madrid, Madrid, Comunidad de, Spanien, 28046
        • Rekruttering
        • Hospital Universitario La Paz
      • Taichung, Taiwan, 407
        • Rekruttering
        • Taichung Veterans General Hospital
      • Taoyuan, Taiwan, 33305
        • Rekruttering
        • Chang Gung Medical Foundation Linkou Chang Gung Memorial Hospital
    • Hsinchu
      • Hsinchu, Hsinchu, Taiwan, 300046
        • Rekruttering
        • Hsinchu Municipal Mackay Children's Hospital
    • Hualien
      • Hualien City, Hualien, Taiwan, 970
        • Rekruttering
        • Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

Ikke ældre end 9 måneder (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria

Participants must meet the following key inclusion criteria to be eligible for enrollment into the study:

  1. Hospitalized with age from birth <9 months, including preterm birth
  2. Part A: Receiving IV antibiotics for treatment of suspected or confirmed bacterial infection, including but not limited to cIAI, cUTI, HAP/VAP, BSI, or sepsis.
  3. Part B: Suspected or confirmed gram-negative bacterial infection requiring IV antibiotics, including but not limited to cIAI, cUTI, HAP/VAP, BSI, or sepsis.

Participants with any of the following characteristics/conditions will be excluded:

  1. Received any other investigational medicinal product within the longer of 30 days or 5 half-lives before enrollment.
  2. Any medical or laboratory abnormality that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study.
  3. Severe renal impairment or known significant renal disease, as evidenced by elevated serum creatinine at screening, or urinary output <0.5 mL/kg/h for 6 consecutive hours or requirement for dialysis.
  4. Part B Only: Received >24 hours of systemic antibiotic treatment for gram-negative organisms at time of enrollment, unless documented treatment failure or lack of improvement in at least one objective sign or symptom of infection after ≥48 hours of antibiotics.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Grundvidenskab
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Part A, Cohorts 1-4

Single dose pharmacokinetics.

Single intravenous infusion of aztreonam-avibactam over 3 hours to assess pharmacokinetics, safety, and toleration.

Eksperimentel: Part B, Cohorts 1-4

Multi-dose pharmacokinetics and treatment

Multiple intravenous infusions of aztreonam-avibactam over 3 hours, repeated every 6-8 hours up to 14 days to assess pharmacokinetics, safety, toleration, and efficacy.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maximum Predicted Plasma Concentration (Cmax) of ATM and AVI
Tidsramme: Up to Day 15

Cmax is the maximum plasma concentration of ATM and AVI as population pharmacokinetic (popPK) analysis predicts.

Up to Day 15
Area under the Concentration-Time Curve (AUC) of ATM-AVI
Tidsramme: Up to Day 15

AUC is a measure of the plasma concentration of ATM and AVI overtime as popPK analysis predicts.

Up to Day 15
Plasma Elimination Half-Life (t1/2)
Tidsramme: Up to Day 15

Half-life is the time measured for the plasma concentration of ATM and AVI to decrease by one half as popPK analysis predicts.

Up to Day 15
Apparent Clearance (CL)
Tidsramme: Up to Day 15

ATM and AVI clearance is a quantitative measure of the rate at which ATM and AVI are removed from the blood (rate at which ATM and AVI are metabolized or eliminated by normal biological processes). Clearance obtained after intravenous infusion dose (apparent clearance) is influenced by the fraction of the dose absorbed.

Up to Day 15
Plasma concentrations of ATM and AVI by nominal sampling time
Tidsramme: Up to Day 15

Plasma concentrations of ATM and AVI on Day 1 and at steady state (Day 2 or later) will be summarized by the nominal sampling time using descriptive statistics (eg number, mean, standard deviation).

Up to Day 15
Proportion of Participants reporting Adverse Events (AE)
Tidsramme: Baseline up to Day 50

Proportion of participant AE reports of vital signs, physical examinations, and clinical laboratory tests overall and by age cohort. For each AE the last assessment made prior to the first dose of study drug will be defined as the baseline.

Baseline up to Day 50
Proportion of Participants reporting Serious Adverse Events (SAE)
Tidsramme: Baseline up to Day 50

Proportion of participant SAE reports of vital signs, physical examinations, and clinical laboratory tests overall and by age cohort. For each SAE the last assessment made prior to the first dose of study drug will be defined as the baseline.

Baseline up to Day 50
Proportion of Participants reporting AEs leading to discontinuation of study drug
Tidsramme: Baseline up to Day 50

Proportion of Participants reporting AEs leading to discontinuation of study drug from baseline. For each discontinuation the last assessment made prior to the first dose of study drug will be defined as the baseline.

Baseline up to Day 50
Proportion of Participants reporting AEs resulting in death
Tidsramme: Baseline up to Day 50

Proportion of Participants reporting AE resulting in death from baseline. For each death the last assessment made prior to the first dose of study drug will be defined as the baseline.

Baseline up to Day 50
Proportion of Participants reporting liver injury and acute kidney injury
Tidsramme: Baseline up to Day 50

Proportion of Participants reporting liver injury and acute kidney injury from baseline. For each report of liver and acute kidney injury the last assessment made prior to the first dose of study drug will be defined as the baseline.

Baseline up to Day 50

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Part B: Proportion of participants with each clinical outcome and with a favorable clinical outcome at end of IV study treatment (EOIV)
Tidsramme: Up to 15 days after start of IV study treatment

Clinical Cure is defined baseline signs and symptoms improved such that no further antimicrobial treatment is required for an aerobic gram-negative baseline infection. Participants who receive treatment for gram-positive organisms or adjunctive therapy for Pseudomonas aeruginosa, as allowed per protocol, can still have a response of cure. Clinical improvement is defined as baseline signs and symptoms sufficiently improved to allow switching to an oral antibiotic treatment. A favorable outcome is clinical cure or clinical improvement. Failure is defined as a requirement for further antibiotic treatment, including following premature discontinuation due to an adverse event, or death after receiving at least 48 hours of treatment. Indeterminant is defined as data not available for evaluation of efficacy for any reason.

Up to 15 days after start of IV study treatment
Part B: Proportion of participants with each clinical outcome and with a favorable clinical outcome at end of treatment (EOT)
Tidsramme: Within 48 hours after last dose of oral switch treatment

EOT is only applicable for participants switched to an oral antibiotic treatment. Possible outcomes are cure, failure, or indeterminant.

Within 48 hours after last dose of oral switch treatment
Part B: Proportion of participants with each clinical outcome and with a favorable clinical outcome at test of cure (TOC)
Tidsramme: 7-14 days after the last study treatment

Possible outcomes are cure, failure, or indeterminant.

7-14 days after the last study treatment
Part B: Proportion of participants with a favorable microbiological response at TOC
Tidsramme: 7-14 days after the last study treatment

A favorable response is eradication or presumed eradication. Eradication is absence of the causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication is when a repeat culture was not performed and the clinical response is cure.

7-14 days after the last study treatment
Part B: Counts and proportions of pathogens with each per-pathogen microbiological response at EOIV/EOT
Tidsramme: Up to 15 days after start of IV study treatment

Possible outcomes are eradication, presumed eradication, persistence, presumed persistence or indeterminate. Presumed eradication/persistence based on repeat culture not performed and clinical outcome of cure/failure. Persistence is the causative pathogen is still present from an appropriately obtained specimen at the site of the infection. Indeterminant includes participant lost to follow-up or death after receiving less than 48 hours of study treatment.

Up to 15 days after start of IV study treatment
Part B: Counts and proportions of pathogens with each per-pathogen microbiological response at TOC
Tidsramme: 7-14 days after the last study treatment

Possible outcomes are eradication, presumed eradication, persistence, presumed persistence or indeterminate.

7-14 days after the last study treatment
Part B: Counts and proportions of participants with emergent infections (new infections or superinfections) during the study
Tidsramme: Through study completion, up to Day 50

Superinfection is defined as emergence of a new pathogen associated with worsening signs and symptoms of infection and a requirement for additional antibiotics during the period up to and including EOIV/EOT. New infection is defined as emergence of a new pathogen associated with worsening signs and symptoms of infection and a requirement for additional antibiotics during the period after EOIV/EOT.

Through study completion, up to Day 50

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Studieleder: Pfizer CT.gov Call Center, Pfizer

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

25. september 2024

Primær færdiggørelse (Anslået)

25. april 2027

Studieafslutning (Anslået)

25. april 2027

Datoer for studieregistrering

Først indsendt

28. maj 2024

Først indsendt, der opfyldte QC-kriterier

14. juni 2024

Først opslået (Faktiske)

17. juni 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • C3601010
  • 2023-507757-15-01 (Registry Identifier: CTIS (EU))
  • 2023 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .