The overall purpose of this study is to support the development of an oral formulation of TBPM-PI-HBr by assessing the potential ecological effects of tebipenem on the normal intestinal microbiota as compared to the effects of oral amoxicillin-clavulanate.
This is a single-center, open-label, randomized, parallel-group, active-control, phase 1 study consisting of 10-day treatment period using TBPM-PI-HBr (600mg) (2× 300mg film coated tablets) or amoxicillin-clavulanate (500mg/125mg) orally every 8 hours (PO q8h \[±1 hour\]) in healthy volunteers. Participants will be randomized by gender to 1:1 ratio on Day 1. A maximum of 30 participants will be randomly assigned to the study treatment groups (15 in each arm) such that approximately 24 evaluable participants complete the study. Due to the multidimensional nature of data of the study, a power statement on a single endpoint is not appropriate. The main aim of the study is to estimate the effects of treatment on the intestinal microbiota, and to assess the pattern of susceptibility to specific pathogens. Based upon previous studies, a sample size of 12 participants in each group is considered sufficient to demonstrate a clinically significant impact of antibiotics on the microbiota. Total duration of study participation for each participant will be approximately 7 months.Screening visit will be performed between Day -28 to Day -1. Randomization will be performed on Day 1 and with treatment being administered from Day 1 to Day 10. Follow-up of participants will occur on Day 14, 21, 90 and 180 with appropriate visit windows. Adverse events and concomitant medications will be recorded until the end of the study (Day 180).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
TBPM-PI-HBr (2 x 300mg tablets) PO q8h \[±1 hour\] for 10 days
amoxicillin-clavulanate (1 × 500mg/125mg tablet) PO q8h \[±1 hour\] for 10 days
Karolinska University Hospital
Huddinge, Stockholm County, Sweden
Changes in the number of microorganisms in the intestinal flora of healthy subjects during and after 10 days of oral administration of TBPM-PI-HBr or amoxicillin-clavulanate
Changes in the number of microorganisms identified in feces
Time frame: Change from baseline (Day-1), at Days 2, 4, 7, 10, 14, 21, 90, and 180
Changes in the types of microorganisms in the intestinal flora of healthy subjects during and after 10 days of oral administration of TBPM-PI-HBr or amoxicillin-clavulanate
Changes in the types of microorganisms identified in feces
Time frame: Change from baseline (Day-1), at Days 2, 4, 7, 10, 14, 21, 90, and 180
To explore the potential for development of resistance by measuring the number of new colonizing bacterial isolates
Emergence of resistant strains with increasing minimum inhibitory concentration values during treatment and post-treatment with tebipenem and amoxicillin-clavulanate will be determined from fecal samples.
Time frame: Change from baseline (Day-1), at Days 2, 4, 7, 10, 14, 21, 90, and 180
To assess the plasma concentrations of tebipenem over 10 days of oral administration of TBPM-PI-HBr.
PK concentration of tebipenem will be measured in plasma. Concentrations of tebipenem will be plotted for each participant.
Time frame: Day 1 through Day 14
To assess the fecal concentrations of tebipenem over 10 days of oral administration of TBPM-PI-HBr.
PK concentration of tebipenem will be measured in feces.Concentrations of tebipenem will be plotted for each participant.
Time frame: Day 1 through Day 14
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
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To assess the incidents of treatment-emergent adverse events following 10 days of oral TBPM-PI-HBr administration
Time frame: Incidents of treatment-emergent adverse events from Day 1 through last follow-up visit (180 days after last dose)
Incidence of abnormal safety laboratory assessments [Safety and Tolerability]
To assess the incidents of abnormal hematology, biochemistry, coagulation and urinalysis assessments following 10 days of oral TBPM-PI-HBr administration
Time frame: Incidents of abnormal safety laboratory assessments from Day 1 through last follow-up visit (180 days after last dose)
Incidence of abnormal vital sign assessments [Safety and Tolerability]
To assess the incidents of abnormal heart rate, blood pressure and body temperature assessments following 10 days of oral TBPM-PI-HBr administration
Time frame: Incidents of abnormal vital sign assessments from Day 1 through last follow-up visit (180 days after last dose)
Incidence of abnormal physical exam assessments [Safety and Tolerability]
To assess the incidents of abnormal body system assessments following 10 days of oral TBPM-PI-HBr administration
Time frame: Incidents of abnormal physical exam assessments from Day 1 through last follow-up visit (180 days after last dose)