This is an open-label, multicentre, randomized, parallel group study to evaluate the efficacy of treatment with oxygen-ozone therapy plus oral antibiotic therapy, in comparison with oral antibiotic therapy alone, in the proportion of patients with resolution/improvement of signs and symptoms of infection of the wound (e.g. ulcer, eschar, sore) in the target lesion after 14 days of treatment, in patients with infections secondary to implant of orthopaedic devices.
This will be an open-label, multicentre, randomized, parallel group study. The study plan will include a screening visit (Visit 1, Day -7/-3) in which patients will be screened on the basis of inclusion/exclusion criteria and clinically evaluated. At the end of the 3-7 days of run-in (Visit 2, Baseline visit, Day 0), patient still eligible will be randomised to one of the two following treatment groups: 1. Oxygen-ozone therapy SIOOT plus antibiotic therapy 2. Antibiotic therapy Patients in both groups will receive oral antibiotic therapy, which will be prescribed at discretion of the Investigator, based on the results of the colture of the swab collected in the target lesion at the screening visit (and later, if needed) and the associated antibiogram. Follow-up visits will be performed after 7 days (Visit 3, Day 7), 14 days (Visit 4, Day 14), 28 days (Visit 5, Day 28) and 42 days (Visit 6, End of study, Day 42) from the start of treatment. A visit window of ± 2 days for the date of Visits 3-5 and of ± 3 days for the date of Visits 6 will be allowed. Patients prematurely discontinued from the study will perform an 'Early termination visit', in which procedures schedule for Visit 6 (End of study, Day 42) will be performed. In case of premature study discontinuation, the Investigator will duly record the reason for premature withdrawal in the appropriate section of the case report form (eCRF). Visit 6, or the 'Early termination Visit' will represent the conclusion of patient's participation in the investigation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
186
Oxygen-ozone therapy (group a) will be performed by: i) Self-haemoinfusion of 200 cc. with concentrations of 40-50 μg/ml, to be performed two/three times a week, for a time of 6 weeks (for a maximum of 15 sessions); ii) Subcutaneous injections in the perilesional site at the dose of 5 cc. with concentrations of 4 μg,/ml, Cleanse wounds with 100 cc of 5-10 ug ozone gas
Pineta Grande Hospital
Castel Volturno, Caserta, Italy
RECRUITINGOspedali Riuniti Torrette
Ancona, Italy
NOT_YET_RECRUITINGUniversità Federico II
Napoli, Italy
NOT_YET_RECRUITINGAzienda Ospedaliera Universitaria Policlinico Paolo Giaccone di Palermo
Palermo, Italy
NOT_YET_RECRUITINGFondazione IRCCS Policlinico San Matteo
Pavia, Italy
NOT_YET_RECRUITINGCasa Di Cura Citta' Di Roma
Roma, Italy
NOT_YET_RECRUITINGClinical success at Day 14
Resolution/improvement of signs and symptoms of infection of the wound in the target lesion (i.e. a score ≤ 1 for a maximum of two signs/symptoms) from baseline to Day 14. The following symptoms will be evaluated by patients on a 0-4 point Likert scale (0 = no symptom; 1 = mild symptom; 2 = moderate symptom; 3 = severe symptom; 4 = very severe symptom): pain, burning, redness and malodour. The following signs will be evaluated by investigators on a 0-4 point Likert scale (0 = no sign; 1 = mild sign; 2 = moderate sign; 3 = severe sign; 4 = very severe sign): erythema, local warmth, swelling, purulent secretion.
Time frame: 2 week
Proportion of patients with clinical success at Day 7, Day 28, and Day 42
Clinical success is defined as resolution/improvement of signs and symptoms of infection of the wound in the target lesion
Time frame: Day 7, Day 28, and Day 42
Time to resolution of all signs and symptoms of infection
It is defined as the disappearance (score = 0) of all signs and symptoms of infection of the wound in the target lesion;
Time frame: 7 weeks
Eradication of the pathogen isolated at the screening visit
Bacteriological success of the wound in the target lesion at Day 14 (V4) and Day 42 (V6).A bacteriological success is defined as eradication of the pathogen isolated at the screening visit, without superinfection or reinfection with the same pathogen;
Time frame: 7 weeks
Changes from baseline to any post-baseline time-point of the size of the target lesion
Time frame: 7 weeks
Global assessment of the target lesion at Day 14 and Day 42
Investigators will be requested to score the outcome of the target lesion on a five-grade scale: 1= worsening, 2 = no change, 3 = minimal improvement, 4 = moderate improvement and 5 = good improvement/resolution;
Time frame: 7 weeks
Changes from baseline to any post-baseline time-point in body temperature
Time frame: 7 weeks
Changes in WBCs count
Changes from baseline to Day 14 (V4) and Day 42 (V6) of white blood cells count (a laboratory parameters that is indicative of infection)
Time frame: 7 weeks
Changes in Erythrocyte sedimentation rate
Changes from baseline to Day 14 (V4) and Day 42 (V6) of ESR values (a laboratory parameters that is indicative of infection)
Time frame: 7 weeks
Changes in High-sensitivity C-reactive protein
Changes from baseline to Day 14 (V4) and Day 42 (V6) of hs-CRP values (a laboratory parameters that is indicative of infection)
Time frame: 7 weeks
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