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头孢托洛嗪/他唑巴坦与美罗培南治疗定植有超广谱 β 内酰胺酶(产生病原体)或有感染风险的患者出现发热性中性粒细胞减少症 (CLEMENT)

2026年9月15日 更新者:Beneficência Portuguesa de São Paulo

头孢托洛嗪/他唑巴坦与美罗培南治疗感染超广谱 β 内酰胺酶 (ESBL) 病原体定植或有感染风险的患者的发热性中性粒细胞减少症:一项随机双盲非劣效性试验。

The study proposes a planned, double-blind, non-inferiority clinical trial involving patients with febrile neutropenia and risk of extended-spectrum beta-lactamase (ESBL) infection. The goal is:

- Analyze the efficacy and tolerability of Ceftolozane/tazobactam (CEF/TAZ) compared to the current standard of care (meropenem) in patients with febrile neutropenia and risk of ESBL infection.

Patients will be randomly assigned to receive CEF/TAZ or meropenem, with assessment of clinical response, toxicity and microbiological evolution. Stool samples will be collected before, during and after treatment for intestinal microbiota analysis and intestinal microbiome analysis to evaluate possible effects on GVHD. Analysis of the results will include the taxonomic classification of the organisms present. Data will be analyzed to assess non-inferiority in clinical response, incidence of GVHD, antimicrobial resistance and other outcomes.

研究概览

研究类型

介入性

注册 (估计的)

55

阶段

  • 第四阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习联系方式

  • 姓名:Research Department
  • 电话号码:+55 11 3505 5031
  • 邮箱:naipe@bp.org.br

研究联系人备份

学习地点

      • São Paulo、巴西
        • 招聘中
        • A Beneficência Portuguesa de São Paulo
        • 接触:
          • João Prats, MD
          • 电话号码:+55 11 3505 5031

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion criteria:

- Individuals who present with the onset of febrile neutropenia and at the same time present colonization with an ESBL-producing pathogen (identified through positive routine rectal swabs and/or positive culture of clinical specimen) or risk of infection with an ESBL-producing pathogen (use of 3rd/4th gen cephalosporin or piperacillin/tazobactam for at least 48 hours in the last 30 days).

Exclusion Criteria:

  • Patients known to be colonized with carbapenem-resistant or CEF/TAZ-resistant pathogens
  • Patients with previous use of carbapenems for at least 48h in the past 30 days are also excluded due to risk of resistance to the study drugs.
  • Growth of a pathogen resistant to either study drug in a relevant clinical specimen during the intervention phase will be followed by adjustment of therapy according to local protocol, unblinding, and exclusion from the study.
  • Patients that have received less than 72h of either study drug will also be excluded from the final analyses.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:四人间

武器和干预

参与者组/臂
干预/治疗
实验性的:Intervention

In the intervention arm 3g of ceftolozane-tazobactam are given intravenously every 8 hours. Duration of therapy should follow local guidelines and de-escalation is allowed after identification of causative pathogens.

Colonized patients will be considered those identified through positive routine rectal swabs and/or positive culture of a clinical sample) or at risk of infection by an ESBL-producing pathogen due to use of 3rd/4th gen cephalosporin or piperacillin/tazobactam for at least 48 hours. in the last 30 days.

In the intervention arm 3g of ceftolozane-tazobactam are given intravenously every 8 hours. Duration of therapy should follow local guidelines and de-escalation is allowed after identification of causative pathogens.

有源比较器:Control

The comparator arm consists of 2g of meropenem given intravenously every 8 hours.Duration of therapy should follow local guidelines and de-escalation is allowed after identification of causative pathogens.

Colonized patients will be considered those identified through positive routine rectal swabs and/or positive culture of a clinical sample) or at risk of infection by an ESBL-producing pathogen due to use of 3rd/4th gen cephalosporin or piperacillin/tazobactam for at least 48 hours. in the last 30 days.

The comparator arm consists of 2g of meropenem given intravenously every 8 hours.Duration of therapy should follow local guidelines and de-escalation is allowed after identification of causative pathogens.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Percentage of Participants with regards to clinical failure of antimicrobial therapy at the End-of-Therapy (EOT) Visit in the Intent-to-Treat (ITT) Population
大体时间:Within 24 hours after last dose of study drug (Up to ~Day 15)

To compare the clinical response rates at the EOT visit for ceftolozane/tazobactam versus meropenem. Clinical response at the EOT visit was defined as cure (complete resolution of fever and symptoms related to Febrile Neutropenia episode), failure (non-resolution, relapse or recurrence of Febrile Neutropenia) or indeterminate (no evaluable study data). A favorable clinical response is a clinical cure. A missing clinical response will be considered indeterminate.

Within 24 hours after last dose of study drug (Up to ~Day 15)

次要结果测量

结果测量
措施说明
大体时间
Percentage of Participants With Clinical Response of Clinical Cure at the End-of-Therapy (EOT) Visit in the Microbiological Intent-to-Treat (mITT) Population
大体时间:7 to 14 days after last dose of study drug (Up to ~Day 30)

To compare the clinical response rates at the EOT visit for ceftolozane/tazobactam versus meropenem in the Microbiological Intent-to-Treat (mITT) Population. Clinical response at the EOT visit was defined as cure (complete resolution of fever and symptoms related to Febrile Neutropenia episode), failure (non-resolution, relapse or recurrence of Febrile Neutropenia) or indeterminate (no evaluable study data). A favorable clinical response is a clinical cure. A missing clinical response will be considered indeterminate.

7 to 14 days after last dose of study drug (Up to ~Day 30)
Percentage of Participants With Clinical Response of Clinical Cure at the Test-of-Cure (TOC) Visit in the Intent-to-Treat (ITT) Population
大体时间:7 to 14 days after last dose of study drug (Up to ~Day 30)

To demonstrate the non-inferiority of ceftolozane/tazobactam versus meropenem in participants with Febrile Neutropenia on Patients Colonized With or at Risk for Infection With Extended Spectrum Beta Lactamase - Producing Pathogens at the TOC visit (7 to 14 days after the end-of-therapy [EOT] visit) using a non-inferiority margin of 12.5%. Clinical response at the TOC visit was defined as cure (complete resolution of fever and symptoms related to Febrile Neutropenia), failure (non-resolution, relapse or recurrence of Febrile Neutropenia) or indeterminate (no evaluable study data). A favorable clinical response is a clinical cure. A missing clinical response will be considered indeterminate unless the clinical outcome at the EOT visit was failure.

7 to 14 days after last dose of study drug (Up to ~Day 30)
Incidence of microbiologically documented infections and identification of causative organisms in culture
大体时间:Up to 100 days

The incidences of microbiologically documented infections, along with the identification of causative organisms in culture, will be recorded. The measure will be assessed through the counting of cases confirmed by positive cultures.

Up to 100 days
In-hospital mortality
大体时间:Until100 days after allogenic HSCT

In-hospital mortality in the first 100 days after allogenic hematopoietic stem cell transplant (HSCT)

Until100 days after allogenic HSCT
Occurrence of graft versus host disease (GVHD)
大体时间:Until100 days after allogenic HSCT

Occurrence of GVHD In the first 100 days after allogenic HSCT

Until100 days after allogenic HSCT
Frequency of multidrug resistant-pathogen infections or colonization
大体时间:Until100 days after allogenic HSCT

Frequency of multidrug resistant-pathogen infections or colonization by weekly rectal swab screening

Until100 days after allogenic HSCT
Faecal microbiota analysis
大体时间:Up to 100 days

Patients will also undergo faecal microbiota analysis on baseline and at the end of therapy as a surrogate marker for future GVHD.

Up to 100 days
Percentage of Participants Who Report 1 or More Adverse Event (AE)
大体时间:Up to 35 days after last dose of study drug

An AE is any untoward medical occurrence in a participant administered a pharmaceutical product that does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not related to the medicinal product.

Up to 35 days after last dose of study drug
Percentage of Participants With Any Serious Adverse Event (SAE)
大体时间:Up to 35 days after last dose of study drug (Up to ~Day 50) ]

A serious adverse event (SAE) is an AE that results in death, is life threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment.

Up to 35 days after last dose of study drug (Up to ~Day 50) ]
Percentage of Participants Discontinuing Study Drug Due to an Adverse Event (AE)
大体时间:Up to 14 days after the first dose of study drug (Up to ~Day 15)

An AE is any untoward medical occurrence in a participant administered a pharmaceutical product that does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not related to the medicinal product.

Up to 14 days after the first dose of study drug (Up to ~Day 15)

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:João Prats, MD、Beneficência Portuguesa de São Paulo

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2025年3月26日

初级完成 (估计的)

2027年8月1日

研究完成 (估计的)

2027年12月1日

研究注册日期

首次提交

2024年2月29日

首先提交符合 QC 标准的

2024年3月28日

首次发布 (实际的)

2024年4月2日

研究记录更新

最后更新发布 (实际的)

2026年9月18日

上次提交的符合 QC 标准的更新

2026年9月15日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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