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APLAUD-Studie (Antibiotika vs Placebo bei akuter unkomplizierter Divertikulitis)

17. September 2026 aktualisiert von: Alexander Hawkins, Vanderbilt University Medical Center

Vergleich von Placebo mit Antibiotika bei akuter unkomplizierter Divertikulitis

The goal of this clinical trial is to determine whether antibiotics improve recovery from acute uncomplicated diverticulitis (AUD) in racially and ethnically diverse United States clinical practice. The main questions it seeks to answer are:

  • What is the feasibility for completing a subsequent definitive efficacy trial of antibiotics vs. placebo to treat AUD?
  • What are the needs for successful recruitment of racial and ethnic subgroups?
  • What are the effects of a placebo compared to antibiotics for AUD on a range of key patient-centric efficacy and safety endpoints?
  • How do such effects differ by race and ethnicity? Researchers will compare a placebo to antibiotics to see if AUD can be treated without using antibiotics.

Participants will:

  • Take two antibiotics or a matching placebo every day for 10 days
  • Receive analgesia, gastric protection, diet modifications, and a follow-up
  • Submit daily photos of pills to the study team to verify adherence

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

100

Phase

  • Phase 2

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

    • Tennessee
      • Nashville, Tennessee, Vereinigte Staaten, 37235
        • Rekrutierung
        • Vanderbilt University Medical Center Emergency Department
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre bis 90 Jahre (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Patients presenting to the emergency department with left-sided uncomplicated diverticulitis
  • Radiologic score (moderate diverticulitis per Ambrosetti classification)
  • Age 18-90
  • Access to a smartphone with internet access.

Exclusion Criteria:

  • Complicated diverticulitis (abscess, free air, peritonitis)- severe diverticulitis by Ambrosetti classification
  • Diverticulitis other than left colon
  • Contraindication to use of study medication (ie advanced renal failure or allergy to all antibiotics used in the study)
  • Concurrent cancer diagnosis
  • Concurrent IBD Diagnosis
  • Any other disease process with life expectancy < 6 months
  • Concurrent chronic pain diagnosis.
  • Women in pregnancy or breastfeeding
  • Antibiotic treatment for any reason in the last 3 weeks
  • Diagnosis of prior episode of acute diverticulitis in the past 3 months
  • Significant comorbidities: diabetes mellitus with organic involvement (retinopathy, angiopathy, nephropathy), emergency assistance for a cardiogenic event in the last 3 months (acute myocardial infarction, angina, heart failure), decompensation of chronic liver disease in the last 3 months (Child ≥ B) and end-stage renal disease.
  • Immunodepression: the absence, and immunodepression is the presence, of any of the following: active neoplastic disease, hematologic malignancy, human immunodeficiency virus long-term corticosteroid treatment, immunosuppressant therapy (20mg pred (or equivalent) for >2 weeks), transplant, splenectomy and genetic immunodeficiency
  • Previous colectomy
  • Patients with dementia, memory disorders or other cognitive impairment that would impact their ability to provide informed consent or otherwise participate in the trial

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Vervierfachen

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Aktiver Komparator: Antibiotic

The primary antibiotic choice will be amoxicillin-clavulanate (1 tablet [875 mg amoxicillin; 125 mg clavulanic acid] every 8 hours). If the subject has an allergy or contraindication to the primary antibiotic, we will administer cefuroxime [500 mg] every 12 hours plus metronidazole [500 mg] every 12 hours.

amoxicillin-clavulanate:1 tablet [875 mg amoxicillin; 125 mg clavulanic acid] every 8 hours

metronidazole: 500 mg every 12 hours

cefuroxime: 500 mg every 12 hours

Experimental: Placebo

A placebo matching the antibiotic arm's treatment regimen will be administered for 10 days

A placebo matching the antibiotic arm's treatment regimen will be administered for 10 days

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Recruitment Rate
Zeitfenster: From enrollment through study completion, an average of 2 years.

Patients recruited per week

From enrollment through study completion, an average of 2 years.
Adherence
Zeitfenster: From enrollment through study completion, an average of 2 years

Percent of patients completing the course of antibiotics/placebo

From enrollment through study completion, an average of 2 years
Data completeness
Zeitfenster: From enrollment through study completion, an average of 2 years

Percentage of participants for whom a complete data set was collected

From enrollment through study completion, an average of 2 years
Retention
Zeitfenster: From enrollment through study completion, an average of 2 years

Percentage of patients completing all study activities

From enrollment through study completion, an average of 2 years
Acceptability
Zeitfenster: Collected at 14 days and 6 months

Measured by the Acceptability of Intervention Measure (AIM). Four-question survey with scores ranging from 4 (least acceptable) to 20 (most acceptable).

Collected at 14 days and 6 months
Cross over
Zeitfenster: From enrollment through study completion, an average of 2 years

Defined as the number of placebo subjects that ended up being treated with antibiotics

From enrollment through study completion, an average of 2 years

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Barratt Simplified Measure of Social Status (BSMSS)
Zeitfenster: Collected at the time of enrollment

BSMSS provides an education, occupation, and overall proxy score for socioeconomic status. Scored on a scale of 8-66, with higher scores indicating higher socioeconomic status.

Collected at the time of enrollment
Brief Health Literacy Scale (BHLS)
Zeitfenster: Collected at enrollment

3-item questionnaire, scored on a scale of 1-5 with 5 being the highest degree of health literacy

Collected at enrollment
Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10)
Zeitfenster: Collected at the time of enrollment, 30 days, and 6 months

The PROMIS-10 assesses an individual's mental health (four items) and physical health (four items) domains. The total raw scores are translated into standardized T-scores with a mean of 50 and a SD of 10

Collected at the time of enrollment, 30 days, and 6 months
Diverticulitis quality of life (DV-QOL) instrument
Zeitfenster: Collected at enrollment, then 14 and 30 days into the study.

This instrument was designed and validated to measure patient-reported burden of diverticular disease. It is a 17-question survey of patient-reported burden of disease focused on those with uncomplicated diverticular disease. The survey has raw scores 0-68, with higher scores indicating greater impact of diverticulitis on the patient's quality of life. The raw scores are scaled to a 10-point scale.

Collected at enrollment, then 14 and 30 days into the study.
Patient-Reported Outcomes Measurement Information System, Gastrointestinal
Zeitfenster: Collected at enrollment and 14 days into study

5 item survey that assesses abdominal pain, scored 5-25 with higher scores indicating more severe abdominal pain

Collected at enrollment and 14 days into study
Time to normalization of abdominal pain intensity
Zeitfenster: Collected at enrollment, daily for 30 days, and at 6 months

11-point numerical rating scale (NRS) from 0 (no pain) to 10 (worst possible pain) that asks subjects daily to rate their worst abdominal pain over the past 24-hours

Collected at enrollment, daily for 30 days, and at 6 months
Rate of Progression to Complicated Diverticulitis
Zeitfenster: Collected at enrollment, 14 days, 30 days, and 6 months

Captured via review of the EMR and any follow up CT scans

Collected at enrollment, 14 days, 30 days, and 6 months
Rate of persistent diverticulitis at 30 days
Zeitfenster: Collected 30 days from enrollment

DV-QOL scores below the patient acceptable symptom state threshold of 3.2/10

Collected 30 days from enrollment
Rate of diverticulitis-related hospitalization, percutaneous drainage and colectomy
Zeitfenster: From enrollment through study completion, an average of 2 years

Collected from EMR and patient queries

From enrollment through study completion, an average of 2 years
Mortality
Zeitfenster: From enrollment through study completion, an average of 2 years

Obtained from Social Security Administration Death Master File

From enrollment through study completion, an average of 2 years
Adverse Drug Events
Zeitfenster: From enrollment through study completion, an average of 2 years

Including, but not limited to rash, diarrhea, urticaria and anaphylaxis will be captured using self-reported surveys with review of the EMR

From enrollment through study completion, an average of 2 years
Return to normal activity
Zeitfenster: From enrollment through study completion, an average of 2 years

For subjects who currently are employed, the researchers will ask baseline information about past-month work absenteeism (missed work due to health) and presenteeism (impaired work due to health). The subject will complete the validated Work Productivity and Activity Impairment questionnaire. At each follow up period, the researchers will repeat these measures and inquire if they had suffered an adverse work event (firing, demotion) and if they have had to go on any leave.

This is a 6- item instrument on a visual analog scale of 0-10. Scores for each item are multiplied by 100 to calculate percentages. The WPAI calculates percentage impairment (maximum 100%) with higher numbers representing greater work impairment.

From enrollment through study completion, an average of 2 years
Recurrence
Zeitfenster: From 8 weeks into the study through study completion, an average of 2 years

CT-proven acute diverticulitis after complete resolution of symptoms more than 2 months after initial evaluation in the ED. This will be captured by review of the EMR and direct patient query

From 8 weeks into the study through study completion, an average of 2 years

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Mitarbeiter

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

7. Juli 2026

Primärer Abschluss (Geschätzt)

1. April 2028

Studienabschluss (Geschätzt)

1. Oktober 2028

Studienanmeldedaten

Zuerst eingereicht

11. März 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

18. März 2026

Zuerst gepostet (Tatsächlich)

25. März 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

21. September 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

17. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 251398
  • 1R01DK141523-01A1 (US NIH Stipendium/Vertrag)

Plan für individuelle Teilnehmerdaten (IPD)

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UNENTSCHIEDEN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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