Trial Outcomes & Findings for The Safety and Efficacy of an Antibiotic Sponge in Diabetic Patients With Moderately Infected Foot Ulcers (NCT NCT00659646)

NCT ID: NCT00659646

Last Updated: 2022-01-27

Results Overview

Number of participants with a clinical cure in each treatment group at Visit 3 (Day 7). Clinical Cure is defined as positive clinical response and with pathogen eradication.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

56 participants

Primary outcome timeframe

Day 7 of treatment

Results posted on

2022-01-27

Participant Flow

Investigative medical sites

Participant milestones

Participant milestones
Measure
Gentamicin-collagen Sponge and Levofloxacin
Gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Overall Study
STARTED
38
18
Overall Study
COMPLETED
23
10
Overall Study
NOT COMPLETED
15
8

Reasons for withdrawal

Reasons for withdrawal
Measure
Gentamicin-collagen Sponge and Levofloxacin
Gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Overall Study
Protocol Violation
12
8
Overall Study
Adverse Event
1
0
Overall Study
Lost to Follow-up
1
0
Overall Study
protocol noncompliance after randomized
1
0

Baseline Characteristics

The Safety and Efficacy of an Antibiotic Sponge in Diabetic Patients With Moderately Infected Foot Ulcers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Total
n=36 Participants
Total of all reporting groups
Age, Continuous
61.1 years
STANDARD_DEVIATION 9.17 • n=5 Participants
55.1 years
STANDARD_DEVIATION 14.3 • n=7 Participants
59.4 years
STANDARD_DEVIATION 10.9 • n=5 Participants
Sex: Female, Male
Female
9 Participants
n=5 Participants
2 Participants
n=7 Participants
11 Participants
n=5 Participants
Sex: Female, Male
Male
17 Participants
n=5 Participants
8 Participants
n=7 Participants
25 Participants
n=5 Participants
Region of Enrollment
United States
26 Participants
n=5 Participants
10 Participants
n=7 Participants
36 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Day 7 of treatment

Population: modified intent-to-treat

Number of participants with a clinical cure in each treatment group at Visit 3 (Day 7). Clinical Cure is defined as positive clinical response and with pathogen eradication.

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Number of Participants With a Clinical Cure at Visit 3 (Day 7)
0 Participants
3 Participants

SECONDARY outcome

Timeframe: Day 3, 7, 10,14, 21, 28 and 42

Number of patients with positive clinical response, defined as those with a clinical outcome of "clinical cure" or "clinical improvement" in each treatment group at/by each time point

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Number of Participants With a Positive Clinical Response at Each Time Point
Visit 2 Day 3
24 Participants
9 Participants
Number of Participants With a Positive Clinical Response at Each Time Point
Visit 3 Day 7
26 Participants
10 Participants
Number of Participants With a Positive Clinical Response at Each Time Point
Visit 4 Day 10
25 Participants
7 Participants
Number of Participants With a Positive Clinical Response at Each Time Point
Visit 5 Day 14
24 Participants
6 Participants
Number of Participants With a Positive Clinical Response at Each Time Point
Visit 6 Day 21
14 Participants
3 Participants
Number of Participants With a Positive Clinical Response at Each Time Point
Visit 7 Day 28
10 Participants
3 Participants
Number of Participants With a Positive Clinical Response at Each Time Point
Final Study Visit Day 42
22 Participants
10 Participants

SECONDARY outcome

Timeframe: Day 3, 10, 14, 21, 28 & 42

Population: mITT

clinical cure is defined as having a positive clinical response and with pathogen eradication

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7)
Visit 4 Day 10
1 Participants
0 Participants
Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7)
Visit 2 Day 3
0 Participants
0 Participants
Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7)
Visit 5 Day 14
10 Participants
3 Participants
Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7)
Visit 6 Day 21
4 Participants
0 Participants
Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7)
Visit 7 Day 28
9 Participants
1 Participants
Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7)
Final Visit Day 42
22 Participants
7 Participants

SECONDARY outcome

Timeframe: Day 3, 7, 10, 14, 21 & 28

Population: mITT

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=8 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Number of Participants With Pathogen Eradication by Visit
Visit 2 Day 3
20 Participants
1 Participants
Number of Participants With Pathogen Eradication by Visit
Visit 3 Day 7
24 Participants
2 Participants
Number of Participants With Pathogen Eradication by Visit
Visit 4 Day 10
23 Participants
2 Participants
Number of Participants With Pathogen Eradication by Visit
Visit 5 Day 14
18 Participants
2 Participants
Number of Participants With Pathogen Eradication by Visit
Visit 6 Day 21
12 Participants
0 Participants
Number of Participants With Pathogen Eradication by Visit
Visit 7 Day 28
5 Participants
0 Participants

SECONDARY outcome

Timeframe: Day 3, 7, 10, 14, 21, 28 & 42

Population: mITT

Wound Surface Area was measured in cm² Actual Values Total wound surface area was compared across treatments using 2-sample t-tests. Wound tracings were obtained at study visits by trained study personnel who were blinded to the patient data and regimen. A centralized imaging facility provided both wound perimeter and area measurements.

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 1 Day 1
5.11 cm^2
Standard Deviation 9.249
1.24 cm^2
Standard Deviation 0.998
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 2 Day 3
4.50 cm^2
Standard Deviation 8.53
.92 cm^2
Standard Deviation .78
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 3 Day 7
4.47 cm^2
Standard Deviation 8.19
.76 cm^2
Standard Deviation .707
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 4 Day 10
4.31 cm^2
Standard Deviation 8.730
1.14 cm^2
Standard Deviation 0.760
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 5 Day 14
4.14 cm^2
Standard Deviation 9.041
0.95 cm^2
Standard Deviation .656
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 6 Day 21
2.93 cm^2
Standard Deviation 5.517
1 cm^2
Standard Deviation 0.671
Change From Baseline in Total Wound Surface Area Measured in cm^2
Visit 7 Day 28
2.67 cm^2
Standard Deviation 5.474
.93 cm^2
Standard Deviation 0.606
Change From Baseline in Total Wound Surface Area Measured in cm^2
Final Study Visit Day 42
3.73 cm^2
Standard Deviation 9.047
.64 cm^2
Standard Deviation .846

SECONDARY outcome

Timeframe: Days 1 through 49

Population: mITT

clinical cure is defined as having a positive clinical response and with pathogen eradication

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Time to Clinical Cure
21 Days
Interval 14.0 to 28.0
14 Days
Interval 7.0 to 40.0

SECONDARY outcome

Timeframe: Day 3, 7, 10, 14, 21, 28 & 42

Measured on a Visual Analog Pain Scale (VAS) with the lowest possible value of 0 and highest 100 (0 - 100) at each time point. A lower score is better which means the patient experience lower pain. The score is calculated using the number of hours \* the VAS score. This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. For each measure outcome - the minimum score is "0" and the maximum score is 100\* the number of hours in that period.

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=26 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Visual Analog Scale (VAS) for Pain Assessment
Visit 1 Day 1
39.2 score on a scale*days
Standard Deviation 36.79
26.3 score on a scale*days
Standard Deviation 21.77
Visual Analog Scale (VAS) for Pain Assessment
Visit 2 Day 3
27.6 score on a scale*days
Standard Deviation 32.22
18.7 score on a scale*days
Standard Deviation 19.60
Visual Analog Scale (VAS) for Pain Assessment
Visit 3 Day 7
17.5 score on a scale*days
Standard Deviation 23.58
12.6 score on a scale*days
Standard Deviation 19.67
Visual Analog Scale (VAS) for Pain Assessment
Visit 4 Day 10
17.2 score on a scale*days
Standard Deviation 23.34
13.6 score on a scale*days
Standard Deviation 20.98
Visual Analog Scale (VAS) for Pain Assessment
Visit 5 Day 14
13.3 score on a scale*days
Standard Deviation 20.99
13.2 score on a scale*days
Standard Deviation 21.45
Visual Analog Scale (VAS) for Pain Assessment
Visit 6 Day 21
22.9 score on a scale*days
Standard Deviation 34.20
14.3 score on a scale*days
Standard Deviation 22.28
Visual Analog Scale (VAS) for Pain Assessment
Visit 7 Day 28
14.3 score on a scale*days
Standard Deviation 30.96
9.3 score on a scale*days
Standard Deviation 10.07
Visual Analog Scale (VAS) for Pain Assessment
Final Study Visit Day42
17.3 score on a scale*days
Standard Deviation 28.84
2.3 score on a scale*days
Standard Deviation 28.84

SECONDARY outcome

Timeframe: Days 3, 7, 10, 14, 21, 28, 42

The Lipsky wound scoring scale consists of scoring categories for purulent drainage, non-purulent drainage, erythema, induration, tenderness, pain, local warmth and wound measurements. This wound scoring system allows us to take the size and depth of the wound into consideration as well as all signs and symptoms of inflammation and infection. A quantitative score that assess wounds both at baseline and during therapy to compare wound scores over time. The higher the score the worse the inflammation and/or infection is. The Lowest score possible is "3" and the highest score possible is "64".

Outcome measures

Outcome measures
Measure
Gentamicin Sponge
n=24 Participants
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=10 Participants
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Lipsky Wound Score
Final Study Visit Day 42
6.18 score on a scale
Standard Deviation 4.239
4.80 score on a scale
Standard Deviation 2.251
Lipsky Wound Score
Visit 1 Day 1
17.67 score on a scale
Standard Deviation 4.498
13.10 score on a scale
Standard Deviation 5.043
Lipsky Wound Score
Visit 2 Day 3
13.58 score on a scale
Standard Deviation 4.373
11 score on a scale
Standard Deviation 3.771
Lipsky Wound Score
Visit 3 Day 7
10.79 score on a scale
Standard Deviation 4.364
7.60 score on a scale
Standard Deviation 4.300
Lipsky Wound Score
Visit 4 Day 10
9.17 score on a scale
Standard Deviation 4.108
8.29 score on a scale
Standard Deviation 3.147
Lipsky Wound Score
Visit 5 Day 14
8.36 score on a scale
Standard Deviation 4.315
5.33 score on a scale
Standard Deviation 1.633
Lipsky Wound Score
Visit 6 Day 21
7.29 score on a scale
Standard Deviation 3.970
4.33 score on a scale
Standard Deviation 2.309
Lipsky Wound Score
Visit 7 Day 28
5.10 score on a scale
Standard Deviation 2.87
3.67 score on a scale
Standard Deviation 1.155

Adverse Events

Gentamicin Sponge

Serious events: 5 serious events
Other events: 4 other events
Deaths: 0 deaths

Levofloxacin

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Gentamicin Sponge
n=38 participants at risk
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=18 participants at risk
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Infections and infestations
Cellulitis
2.6%
1/38 • Number of events 1 • Day 42
0.00%
0/18 • Day 42
Infections and infestations
Infected skin ulcer
0.00%
0/38 • Day 42
5.6%
1/18 • Number of events 1 • Day 42
Injury, poisoning and procedural complications
Tendon rupture
2.6%
1/38 • Number of events 1 • Day 42
0.00%
0/18 • Day 42
Metabolism and nutrition disorders
Hypoglycaemia
2.6%
1/38 • Number of events 1 • Day 42
0.00%
0/18 • Day 42
Renal and urinary disorders
Renal failure
2.6%
1/38 • Number of events 1 • Day 42
0.00%
0/18 • Day 42
Vascular disorders
Wound haemorrhage
2.6%
1/38 • Number of events 1 • Day 42
0.00%
0/18 • Day 42

Other adverse events

Other adverse events
Measure
Gentamicin Sponge
n=38 participants at risk
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing gentamicin-collagen sponge and levofloxacin: Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Levofloxacin
n=18 participants at risk
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing Levofloxacin only: levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Infections and infestations
Tinea pedis
5.3%
2/38 • Number of events 2 • Day 42
0.00%
0/18 • Day 42
Investigations
Blood creatinine increased
5.3%
2/38 • Number of events 2 • Day 42
5.6%
1/18 • Number of events 1 • Day 42

Additional Information

Charlene A. Tucker, MS Executive Director, Medical Writing and Document Management

Innocoll

Phone: 484-406-5211

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: OTHER