Reduction of Spontaneous Prematurity by Antibiotic Treatment (Josamycin)

NCT ID: NCT00718705

Last Updated: 2011-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

3200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-07-31

Study Completion Date

2011-09-30

Brief Summary

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The purpose of this study is to test the effectiveness of an antibiotic treatment (Josamycin) in the case of positive PCR for Ureaplasma spp. and/or Mycoplasma hominis in the second quarter on the risk of premature birth.

Detailed Description

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Infection would be the cause of 40 % of spontaneous premature deliveries. The physiopathological hypothesis accepted is a premature ascent of present bacteria in the low genital ways towards the decidual, the foetal membranes then the amniotic liquid. These bacteria are responsible for an inflammatory reaction to the interface feto-maternal characterized by the production of proinflammatory cytokines and pro-contractants agents (prostaglandins, oxytocin) by the decidual and the membranes.

These mediators cause uterine contractions, a maturation of the uterine collar, a rupture of the membranes then a premature birth.

Several recent publications show on the one hand that Mycoplasma hominis and Ureaplasma spp. are the bacteria most frequently found in the amniotic liquid in the second quarter of the pregnancy and that a positive PCR for these bacteria is associated with a premature birth.

A probable assumption would be that Mycoplasma hominis or Ureaplasma spp. cause a premature birth by infecting the fetal membranes and the decidual, then activating the immune system and the pro-inflammatory production of cytokines. These bacteria are sensitive to antibiotic treatment.

Nevertheless, no randomized controlled trials have been carried out to determine wether an antibiotic treatment would decrease spontaneous prematurity in the case of positive PCR in the amniotic liquid.

Conditions

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Prematurity

Keywords

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Prematurity Ureaplasma spp Mycoplasma Hominis Amniotic fluid Josamycine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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1

josamycin

Group Type EXPERIMENTAL

Josamycin

Intervention Type DRUG

josamycin with posology of 2 grams per day by oral way during 10 days

2

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo with posology of 2 grams per day by oral way during 10 days

Interventions

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Josamycin

josamycin with posology of 2 grams per day by oral way during 10 days

Intervention Type DRUG

Placebo

Placebo with posology of 2 grams per day by oral way during 10 days

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patient older ≥ 18 years
* French speaking
* Women who have an amniocentesis between 15 and 20 weeks of amenorrhoea for an antenatal diagnosis
* Affiliated to social security or an equivalent system
* Karyotype analysis and ultrasound morphological normal (apart from minor signs of trisomy 21)
* Clear amniotic fluid (not contaminated by the mother's blood)
* Gestational age is between 15 WA(day+0) and 20 WA(day+6)
* Patient have not allergy to macrolides
* Do not have cure underway by macrolide
* Patient followed during her pregnancy in an investigator site
* Informed consent and signed

Exclusion Criteria

* No speaking french
* Having an allergy to macrolides
* Having a multiple pregnancy
* Morphological Anomaly
* Patient no consented
* Lactose Intolerance
* Not agreed to participate
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Bayer

INDUSTRY

Sponsor Role collaborator

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gilles KAYEM

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

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Groupe Hospitalier Chenevier-Mondor, CHI

Créteil, , France

Site Status

Countries

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France

References

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Marcellin L, Batteux F, Chouzenoux S, Schmitz T, Lorthe E, Mehats C, Goffinet F, Kayem G. Second-trimester amniotic fluid proteins changes in subsequent spontaneous preterm birth. Acta Obstet Gynecol Scand. 2023 May;102(5):597-604. doi: 10.1111/aogs.14544. Epub 2023 Mar 14.

Reference Type DERIVED
PMID: 36918342 (View on PubMed)

Kayem G, Doloy A, Schmitz T, Chitrit Y, Bouhanna P, Carbonne B, Jouannic JM, Mandelbrot L, Benachi A, Azria E, Maillard F, Fenollar F, Poyart C, Bebear C, Goffinet F. Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. PLoS One. 2018 Nov 7;13(11):e0206290. doi: 10.1371/journal.pone.0206290. eCollection 2018.

Reference Type DERIVED
PMID: 30403730 (View on PubMed)

Other Identifiers

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P060216

Identifier Type: -

Identifier Source: org_study_id