Phase IV, open-label, randomized and multicenter clinical trial to prove that patients with Enterococcus faecalis infective endocarditis treated with an antibiotic treatment as a continuous infusion is non-inferior to the standard treatment, usually administered in hospitalized patients.
The aim of the study is to prove that the continuous infusion of antibiotic treatment for the patients with Enterococcus faecalis infective endocarditis is as effective and safe as the standard treatment. The continuous infusion modality of treatment is expected to provide numerous benefits for individual patients, global health, and for the National Health Care System by reducing to hospital stays from 4-6 weeks to approximately 2-3 weeks and hospital-driven complications. The mortality, rate of serious adverse events, total number of days of antibiotic treatment and days of hospitalization, among others, are included as secondary objectives. This is a pragmatic study as the number or visits performed for the study are similar to the normal clinical follow-up for this patients. Final contact and final visit for the study will be performed at 365 days after the 42 days of treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
284
Continuous intravenous antibiotic infusion during 42 days for Infective Endocarditis
Ampicillin plus ceftriaxone as an intermittent infusion for a minimum of 14 days. After, if the patient is discharged from the hospital, the following treatments, until the 42-day treatment period is completed: 1. Intravenous treatment according to the following regimens: Ampicillin plus ceftriaxone as an intermittent infusion, teicoplanin, daptomycin, dalbavancin or linezolid. 2. Oral treatment according to the following regimens: amoxicillin plus moxifloxacin, amoxicillin plus linezolid, amoxicillin plus rifampin, linezolid plus moxifloxacin or linezolid plus rifampin.
Hospital Universitario de Álava
Alava, Spain
RECRUITINGClinical failure
It is defined as follow: i) Confirmed recurrence of E. faecalis infective endocarditis, ii) all-cause mortality. A composite primary endpoint has been chosen to include both a very clinically relevant variable and a hard variable such as survival
Time frame: One year after the end of the treatment
Therapeutic failure
Number of deaths
Time frame: Up to 12 months after treatment administration
Cardiac surgeries
Number of unplanned cardiac surgeries
Time frame: Up to 12 months after treatment administration
Readmissions
Number of unplanned readmissions
Time frame: Up to 12 months after treatment administration
Adverse events
Number of medication-related adverse events
Time frame: From randomisation until 30 days after the last dose administration
Antibiotic treatment days
Number of antibiotic treatment days
Time frame: Up to 12 months after treatment administration
Outpatient Parenteral Antimicrobial Therapy
Number of Outpatient Parenteral Antimicrobial Therapy
Time frame: Up to 12 months after treatment administration
Healthcare-associated infections
Number of healthcare-associated infections
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Hospital Universitario de Cruces
Barakaldo, Spain
ACTIVE_NOT_RECRUITINGHospital Universitario Vall d'Hebron
Barcelona, Spain
NOT_YET_RECRUITINGHospital Clínico de Barcelona
Barcelona, Spain
NOT_YET_RECRUITINGHospital Universitario de Donostia
Donostia / San Sebastian, Spain
ACTIVE_NOT_RECRUITINGHospital Universitario Virgen de las Nieves
Granada, Spain
ACTIVE_NOT_RECRUITINGHospital San Pedro
Logroño, Spain
ACTIVE_NOT_RECRUITINGHospital Universitario Gregorio Marañón
Madrid, Spain
ACTIVE_NOT_RECRUITINGHospital Clínico San Carlos
Madrid, Spain
NOT_YET_RECRUITINGHospital Universitario La Paz
Madrid, Spain
NOT_YET_RECRUITING...and 8 more locations
Time frame: Up to 12 months after treatment administration
Recurrence
Number of recurrence of Enterococcus faecalis infective endocarditis
Time frame: Up to 12 months after treatment administration
Minimum free serum concentration
Minimum free serum concentration of antibiotics used
Time frame: Day 14
Steady-state plasma concentration
Steady-state plasma concentration of antibiotics used
Time frame: Day 14
Pharmacokinetic parameters
Volume of distribution, clearance, elimination constant of antibiotics used
Time frame: Day 14
Minimum Inhibitory Concentration
Minimum Inhibitory Concentration of ampicillin induced by ceftriaxone in the strains responsible for recurrences and control strains
Time frame: Day 14