Pharmacokinetics/Pharmacodynamics (PK/PD) of Fluconazole in Children on Extracorporeal Membrane Oxygenation (ECMO)

NCT ID: NCT01169402

Last Updated: 2017-11-22

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 21 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-07-31
• Study Completion Date: 2013-02-20

Brief Summary

Extracorporeal membrane oxygenation (ECMO) is a form of heart-lung bypass used to support children who suffer heart or lung failure until whatever illness caused that failure can be treated and reversed. While on ECMO, children are at increased risk of infection, including fungal infection. Treatment for fungal infection includes not only antifungal medications but also removal of any large intravenous (IV) lines. Since ECMO requires large IV lines, proper treatment of fungal infections would be difficult if not impossible. The investigators believe that giving prophylactic antifungal medication to all children on ECMO may prevent fungal infections from developing in the first place.

Fluconazole is an antifungal medication that works well against the most common fungal infections and has been shown to be safe in children. Unfortunately, the ECMO machine has the potential to significantly alter the drug levels of medications so the investigators do not know the proper dose of Fluconazole to give children on ECMO. Standard dosing of fluconazole is 12mg per kilogram of body weight given intravenously once daily. Based on preliminary data and modeling from other studies, the investigators think 25mg per kilogram given once weekly will achieve proper drug levels to prevent fungal infections. The investigators have obtained FDA approval to give this dose of fluconazole to children on ECMO who are enrolled in the study. Blood samples will be collected at specific times around the first and second fluconazole doses to describe the PK and drug extraction by the ECMO circuit.

Conditions

Cardiopulmonary Arrest; Fungal Infection

Keywords

extracorporeal membrane oxygenation; ECMO; extracorporeal life support; fluconazole; diflucan; pharmacokinetics; pharmacodynamics

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Fluconazole

Group Type: EXPERIMENTAL

Fluconazole

Intervention Type: DRUG

25mg/kg intravenously once weekly while on ECMO

Interventions

Fluconazole

25mg/kg intravenously once weekly while on ECMO

Intervention Type: DRUG

Other Intervention Names

Diflucan

Eligibility Criteria

Inclusion Criteria

1. <= 17.5 years at the time of enrollment.

2. Sufficient venous access to permit administration of study medication.

3. Supported with either venoarterial (VA) or venovenous (VV) ECMO.

4. Availability and willingness of the parent/legal guardian to provide written informed consent.

Exclusion Criteria

1. Subject with a history of anaphylaxis attributed to an azole.

2. Any other concomitant condition, which in the opinion of the investigator would preclude a subject's participation in the study.

3. Previous participation in this study.

4. Subjects who are receiving or who have received cyclosporine, tacrolimus, or azithromycin in the 72 hours prior to first dose of study product require protocol chair notification prior to enrollment.

5. Pregnancy

• Maximum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Michael Cohen-Wolkowiez

OTHER

Sponsor Role: lead

Responsible Party

Michael Cohen-Wolkowiez

Associate Professor

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Kevin M Watt, MD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

Duke University Medical Center

Durham, North Carolina, United States

Countries

United States

Other Identifiers

Pro00022822

Identifier Type: -

Identifier Source: org_study_id