The purpose of this study is to determine the safe use and evaluate the efficacy/performance of DAV132 in hospitalized patients at high risk for Clostridium difficile infection (CDI) and who receive fluoroquinolones (FQs) for the treatment of acute infections or for prophylaxis of febrile neutropenia.
Da Volterra develops DAV132, a novel therapeutic option preserving the intestinal microbiota, to prevent potentially life-threatening conditions such as CDI or emergence of antibiotic-resistant bacteria. Prevention of CDI remains critical unmet need, especially for patients at high risk of developing such infection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
260
DAV132: * Dosage: 15 g/day activated charcoal (22.5 g/day DAV132) * Route: Oral * Duration: duration of fluoroquinolone treatment + 2 days DAV132 is regulated as a medical device in Europe and as a drug in the United States of America.
Safety endpoint: Proportion of patients having at least one adverse event (AE) related to DAV132 and/or to fluoroquinolones (FQs) and which relationship to product (DAV132 or FQ) is confirmed by the Independent Adjudication Committee (IAC).
The IAC will review AEs according to the IAC charter, including Clostridium difficile infection (CDI) and antibiotic-associated diarrhea (AAD), in a blinded manner across both treatment groups, and confirm whether each AE is related or not to DAV132 and/or to the FQ received by the patient.
Time frame: 51 days after randomization
Safety endpoint: Number of AEs and proportion of patients with at least one AE
Time frame: 51 days after randomization
Efficacy/performance endpoint, clinical:Proportion of patients with CDI
Time frame: 51 days after randomization
Efficacy/performance endpoint, clinical: Proportion of patients with AAD
Time frame: 51 days after randomization
Efficacy/performance endpoint, clinical: Plasma levels of FQs
Time frame: Day 4
Efficacy/performance endpoint, biological: Level of free fecal concentrations of FQs
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: Day 1, Day 4, Day 6, 10 days after the end of FQs
Efficacy/performance endpoint, biological: Level of α-diversity of the intestinal microbiota
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: Day 1, Day 6, 10 days after the end of FQs, and 30 days after the end of FQs
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Multiprofile Hospital for Active Treatment Sveti Ivan Rilski - Kozloduy EOOD Internal Department
Kozloduy, Bulgaria
MHAT "Dr Nikola Vasilev " AD 1
Kyustendil, Bulgaria
MHAT "Dr. Stamen Iliev" AD 4
Montana, Bulgaria
Pernik EOOD Specialized Hospital for Active Treatment of Pulmonary Diseases - Phthisiatry Department
Pernik, Bulgaria
Hosp Ruse EOOD
Rousse, Bulgaria
Multiprofile Hospital for Active Treatment Silistra AD Department of pneumology and phtisiatry
Silistra, Bulgaria
Military Medical Academy, Clinic of Infectious Diseases
Sofia, Bulgaria
UMHATEM N.I.Pirogov Department of internal diseases Clinic of internal diseases
Sofia, Bulgaria
MHAT Sv. Anna Clinic of Urology
Varna, Bulgaria
Universitätskliniken Köln (AöR) Klinik I für Innere Medizin
Cologne, Germany
...and 19 more locations
Efficacy/performance endpoint, biological: Change from D1 of α-diversity of the intestinal microbiota
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: Day 6, 10 days after the end of FQs, and 30 days after the end of FQs
Efficacy/performance endpoint, biological: Levels of β-diversity of the intestinal microbiota
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: Day 6, 10 days after the end of FQs, and 30 days after the end of FQs
Efficacy/performance endpoint, biological: Proportion of patients with resistant bacteria and/or yeasts in feces
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: Baseline and up to 10 days after the end of FQs
Efficacy/performance endpoint, biological: Proportion of patients with at least one occurrence of resistant bacteria and yeasts in feces (among patients negative at baseline)
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: up to 10 days after the end of FQs
Efficacy/performance endpoint, biological: Proportion of patients with acquisition of intestinal colonization by C. difficile (among patients negative at baseline)
Duration of treatment with FQs ranges from 5 to 21 days, at the discretion of the Investigator
Time frame: up to 10 days after the end of FQs