This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a gentamicin-sponge, (B) daily application of a placebo-sponge or (C) no-sponge, in the ratio 2:1:1. Patients will be treated for approximately 28 days and return to the clinic weekly for safety and efficacy assessments. After completing treatment, patients will return to the clinic for scheduled follow-up visits approximately 10, 30, 60 and 90 days after treatment is stopped.
This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized using an electronic randomization system to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a gentamicin-sponge, (B) daily application of a placebo-sponge or (C) no-sponge, in the ratio 2:1:1. The investigator will be blinded to the patient's treatment group assignment and patients randomized to one of the 2 sponge groups will be blinded as to whether the sponge is active or placebo. If a patient has multiple infected ulcers, the assigned treatment will be administered to all infected ulcers. The investigator will determine the highest severity ulcer to be used for all efficacy evaluations and will also determine the size and number of sponges (up to 4) that a patient will use in order to completely cover all infected ulcers. The investigator will prescribe an empiric systemic antibiotic therapy based on protocol instructions. Patients will be treated for approximately 28 days and return to the clinic weekly for safety and efficacy assessments. The investigator will stop study treatment if a patient achieves clinical cure by or after the 3rd treatment visit (approximately study day 15). After completing treatment, patients will return to the clinic for scheduled follow-up visits or until ulcer closure. The final efficacy assessments used in the primary efficacy analyses will be obtained at the first follow-up visit approximately 10 days after treatment is stopped. The remaining follow-up visits will occur at approximately 30, 60 and 90 days after treatment is stopped when patients will be assessed for ulcer closure and any re-infection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
612
Up to 4 topical Gentamicin Collagen Sponges each containing 50 mg of gentamicin sulfate (equivalent to 32.5 mg of gentamicin base)
Matching collagen sponge
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Anniston, Alabama, United States
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Mobile, Alabama, United States
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Mesa, Arizona, United States
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Phoenix, Arizona, United States
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Fayetteville, Arkansas, United States
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Clinical Cure (Resolution of All Clinical Signs and Symptoms of Infection)
The primary efficacy variable is the percent of patients with a clinical outcome of clinical cure (Resolution of all clinical signs and symptoms of infection) at F/U visit 1
Time frame: approximately 10 days after end of treatment
Clinical Cure and Baseline Pathogen Eradication (Resolution of All Clinical Signs and Symptoms of Infection) and Baseline Pathogen Eradication)
Percent of patients with both a clinical outcome of clinical cure (Resolution of all clinical signs and symptoms of infection) and baseline pathogen eradication at F/U visit 1
Time frame: Approximately 10 days after end of treatment
Reinfection (Percent of Patients With Re-infection)
Percent of patients with re-infection
Time frame: Approximately 90 days after end of treatment
Time to Clinical Cure
Actual time to clinical cure (Resolution of all clinical signs and symptoms of infection)
Time frame: Approximately 10 days after end of treatment
Amputation (Percent of Patients That Have an Amputation Associated With the Target Ulcer)
Percent of patients that have an amputation associated with the target ulcer
Time frame: Within approximately 90 days of end of treatment
Ulcer Closure (Percent of Patients With Target Ulcer Closure)
Percent of patients with ulcer closure within approximately 30 days of end of treatment
Time frame: within approximately 30 days of end of treatment
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Jonesboro, Arkansas, United States
Unnamed facility
Little Rock, Arkansas, United States
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Little Rock, Arkansas, United States
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Bakersfield, California, United States
Unnamed facility
Chino, California, United States
...and 76 more locations