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Sulbactam-Durlobactam in CRAB Infection: A Real-World Cohort Study (SD-CRAB)

19. maj 2026 opdateret af: Lingai Pan, Sichuan Provincial People's Hospital

This is a Single-center Real-world Observational Cohort Study of Sulbactam-Durlobactam for Carbapenem-Resistant Acinetobacter Baumannii Infections: Effectiveness, Safety, and Exposure-Response Analysis

This is a multicenter real-world observational cohort study designed to evaluate the effectiveness and safety of sulbactam-durlobactam in patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infections. Patients receiving sulbactam-durlobactam will be compared with those receiving other anti-CRAB regimens during the same period.

The primary outcomes are 28-day all-cause mortality and clinical failure. Secondary outcomes include microbiological clearance, recurrence, length of hospital and ICU stay, duration of mechanical ventilation, and adverse events.

To reduce confounding inherent in observational studies, propensity score methods, including matching and inverse probability weighting, will be applied. A nested therapeutic drug monitoring (TDM) sub-cohort will be established to explore the relationship between drug exposure and clinical outcomes.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a single-center real-world observational cohort study including hospitalized adult patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infections. Patients will be classified into two groups based on treatment exposure: those receiving sulbactam-durlobactam and those receiving alternative anti-CRAB regimens during the same period.

The study aims to evaluate the effectiveness and safety of sulbactam-durlobactam in high-risk populations, including transplant recipients and critically ill patients. The primary outcomes are 28-day all-cause mortality and clinical failure. Secondary outcomes include microbiological clearance, recurrence, ICU length of stay, duration of mechanical ventilation, and treatment-related adverse events.

To minimize bias inherent in observational studies, propensity score matching, inverse probability of treatment weighting (IPTW), and multivariable regression models will be applied to adjust for baseline differences between groups. Landmark analysis will be conducted to address time-related biases.

A nested therapeutic drug monitoring (TDM) sub-cohort will be included. Plasma samples will be collected at predefined time points within a dosing interval, and drug concentrations will be measured using validated LC-MS/MS methods. Population pharmacokinetic modeling will be performed to estimate exposure parameters, including Cmin, Cmax, and AUC. The relationship between drug exposure and clinical outcomes, as well as PK/PD target attainment, will be further explored.

Subgroup analyses will be conducted according to infection status (confirmed infection vs. donor-derived colonization or infection).

Undersøgelsestype

Observationel

Tilmelding (Anslået)

200

Kontakter og lokationer

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

Studiesteder

  • Kina
    • Sichuan
      • Chengdu, Sichuan, Kina, 610072
        • Rekruttering
        • Sichuan Provincial People's Hospital
        • Kontakt:

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Hospitalized adult patients receiving anti-CRAB antimicrobial therapy in real-world clinical practice, including:

  1. patients with confirmed carbapenem-resistant Acinetobacter baumannii (CRAB) infection; or
  2. transplant recipients with donor-derived CRAB colonization or infection receiving early targeted therapy.

Beskrivelse

Inclusion Criteria:

  • Age ≥18 years.

  • Hospitalized patients receiving anti-CRAB antimicrobial therapy, including:

    1. patients with confirmed carbapenem-resistant Acinetobacter baumannii (CRAB) infection based on microbiological testing in combination with clinical evidence of infection; or
    2. transplant recipients with donor-derived CRAB colonization or infection who receive early targeted antimicrobial therapy.
  • Treatment initiation time can be clearly determined.
  • Availability of clinical outcome data.

Exclusion Criteria:

  • Colonization without evidence of active infection.
  • Missing key clinical data.
  • Inability to determine treatment initiation time.
  • Pregnancy or lactation.
  • Patients considered unsuitable by investigators.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Sulbactam-Durlobactam Group
Patients receiving sulbactam-durlobactam within 48 hours after treatment initiation.
Medicin: Sulbactam-Durlobactam
Sulbactam-durlobactam administered according to routine clinical practice for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) infection.
Non-Sulbactam-Durlobactam Group
Patients receiving alternative anti-CRAB regimens during the same period without sulbactam-durlobactam.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
28-day All-Cause Mortality
Tidsramme: Up to 28 days after initiation of anti-CRAB therapy
All-cause mortality occurring within 28 days after initiation of anti-CRAB therapy.
Up to 28 days after initiation of anti-CRAB therapy

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Clinical Failure
Tidsramme: Up to 28 days after initiation of anti-CRAB therapy
Clinical failure defined as lack of clinical improvement, need for escalation of antimicrobial therapy, or death.
Up to 28 days after initiation of anti-CRAB therapy
Length of ICU stay
Tidsramme: Up to 90 days after ICU admission
Duration of ICU stay measured from ICU admission to ICU discharge.
Up to 90 days after ICU admission
Time to clinical improvement
Tidsramme: Up to 28 days after initiation of anti-CRAB therapy
Time from initiation of anti-CRAB therapy to predefined clinical improvement.
Up to 28 days after initiation of anti-CRAB therapy
Microbiological eradication
Tidsramme: Up to 14 days after initiation of anti-CRAB therapy
Microbiological eradication confirmed by follow-up culture negativity.
Up to 14 days after initiation of anti-CRAB therapy

Samarbejdspartnere og efterforskere

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

Sponsor

Sichuan Provincial People's Hospital

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.

Generelle publikationer

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)

11. november 2025

Primær færdiggørelse (Anslået)

11. november 2027

Studieafslutning (Anslået)

11. november 2027

Datoer for studieregistrering

Først indsendt

29. marts 2026

Først indsendt, der opfyldte QC-kriterier

19. maj 2026

Først opslået (Faktiske)

22. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2026-055

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be shared due to institutional policies and patient privacy protection.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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