Trial Evaluating Ambulatory Treatment of Travelers' Diarrhea

NCT ID: NCT01618591

Last Updated: 2016-11-28

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

384 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2016-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of the trial is to develop the evidence on relative efficacy of 3 available single-dose loperamide adjuncted regimens for watery diarrhea and a single-dose regimen, with and without loperamide, for dysentery/febrile diarrhea required for informing decisions among these regimens. Information from this study will be used to develop management guidelines for the diagnosis and management of travelers' diarrhea (TD) among deployed United States and United Kingdom military personnel.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The study will be a multi-site, randomized, double-blind, controlled clinical trial among ambulatory deployed personnel. Patients presenting for care will be clinically assessed and a determination made as to whether they have acute watery diarrhea (AWD) or acute dysentery/febrile diarrhea (ADF). For the AWD arm, patients will be randomized to receive 1 of 3 regimens: (1) rifaximin 1650 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days (120 subjects); (2) azithromycin 500 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days (120 subjects); or (3) levofloxacin 500 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days (120 subjects).

For the ADF arm, patients will be randomized to receive 1 of 2 regimens: (1) azithromycin 1000 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days (75 subjects); or (2) azithromycin 1000 mg as a single dose without loperamide (75 subjects).

Study Procedures (Brief): Baseline exam as well as blood and stool samples will be collected at initial clinic visit. Clinical assessments will be performed at 24 hours, 72 hours, and 7 days. In addition, microbiological cure will be evaluated at 7-d post initiation of treatment. Subjects will have blood drawn to assess for serological conversion to common enteric pathogens, and stool collected at 7- and 21-d . Subjects may also opt in for long-term follow-up at time of enrollment, which will assess for development of post-infectious functional bowel disorders. All subjects will complete a baseline assessment at 7-d visit, and those who opt for the additional follow-up will complete a series of web-based surveys at 3-, 6-, 9-, and 12-m post enrollment.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Acute Watery Diarrhea Dysentery/Febrile Diarrhea

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

diarrhea travelers' diarrhea watery diarrhea enteric illness dysentery gastrointestinal

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Acute Watery Diarrhea

Group Type EXPERIMENTAL

Single dose rifaximin 1650 mg

Intervention Type DRUG

Rifaximin 1650 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Single dose azithromycin 500 mg

Intervention Type DRUG

Azithromycin 500 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Single dose levofloxacin 500 mg

Intervention Type DRUG

Levofloxacin 500 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Acute Dysentery/Febrile

Group Type EXPERIMENTAL

Single dose azithromycin 1000 mg plus loperamide

Intervention Type DRUG

Azithromycin 1000 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Single dose azithromycin 1000 mg plus placebo

Intervention Type DRUG

Azithromycin 1000 mg as a single dose and placebo in lieu of loperamide

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Single dose rifaximin 1650 mg

Rifaximin 1650 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Intervention Type DRUG

Single dose azithromycin 500 mg

Azithromycin 500 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Intervention Type DRUG

Single dose levofloxacin 500 mg

Levofloxacin 500 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Intervention Type DRUG

Single dose azithromycin 1000 mg plus loperamide

Azithromycin 1000 mg as a single dose plus loperamide 4 mg initially followed by 2 mg after each unformed stool, not to exceed 16 mg/day for 2 days

Intervention Type DRUG

Single dose azithromycin 1000 mg plus placebo

Azithromycin 1000 mg as a single dose and placebo in lieu of loperamide

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Active duty military or military beneficiary, 18 years-old or older.
2. Presence of acute diarrhea (3 or more stools in 24 hours or 2 or more stools in 24 hours and associated symptoms such as nausea, vomiting, abdominal cramps or tenesmus) and \<96 hours duration.
3. Eligible for ambulatory management.
4. Able to comply with follow-up procedures.
5. Will remain in country for at least 7 days

Exclusion Criteria

1. Allergy to rifamycins, quinolones, macrolides, or loperamide (not including mild gastrointestinal upset).
2. Antibiotic therapy in the 72 hours prior to presentation (excluding malaria prophylaxis with mefloquine, malarone, chloroquine/proguanil, or doxycycline).
3. Concomitant medications with known drug-drug interactions with any of the study drugs (includes theophylline, digoxin, and warfarin).
4. History of seizures (relative contraindication to quinolones)
5. Positive pregnancy test at presentation (contraindicated with fluoroquinolone therapy). All female subjects will be administered a urine pregnancy test prior to enrollment.
6. Presence of symptoms \>96 hours prior to initiating treatment.
7. Use of \>4 mg loperamide or use of any amount of loperamide for greater than 24 hours prior to enrollment.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Navy Bureau of Medicine and Surgery

FED

Sponsor Role collaborator

Ministry of Defence, United Kingdom

OTHER_GOV

Sponsor Role collaborator

Naval Medical Research Center

FED

Sponsor Role collaborator

Naval Medical Research Unit- 3

FED

Sponsor Role collaborator

United States Army Medical Unit - Kenya

FED

Sponsor Role collaborator

United States Naval Medical Center, Portsmouth

FED

Sponsor Role collaborator

Naval Medical Research Unit- 6

FED

Sponsor Role collaborator

Uniformed Services University of the Health Sciences

FED

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Mark Riddle, CDR, MC, USN

Head, Enteric Diseases Department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Mark Riddle, MD, DrPH

Role: PRINCIPAL_INVESTIGATOR

Naval Medical Research Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

UK Role 3 Joint Force Hospital

Camp Bastion Air Base, , Afghanistan

Site Status

U.S. Naval Expeditionary Base

Camp Lemonnier, , Djibouti

Site Status

Joint Task Force - Bravo

Soto Cano Air Base, , Honduras

Site Status

British Army Training Unit Kenya

Nanyuki, , Kenya

Site Status

Armed Forces Research Institute of Medical Sciences

Bangkok, , Thailand

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Afghanistan Djibouti Honduras Kenya Thailand

References

Explore related publications, articles, or registry entries linked to this study.

Johnson RC, Van Nostrand JD, Tisdale M, Swierczewski B, Simons MP, Connor P, Fraser J, Melton-Celsa AR, Tribble DR, Riddle MS. Fecal Microbiota Functional Gene Effects Related to Single-Dose Antibiotic Treatment of Travelers' Diarrhea. Open Forum Infect Dis. 2021 May 28;8(6):ofab271. doi: 10.1093/ofid/ofab271. eCollection 2021 Jun.

Reference Type DERIVED
PMID: 34189178 (View on PubMed)

Riddle MS, Connor P, Fraser J, Porter CK, Swierczewski B, Hutley EJ, Danboise B, Simons MP, Hulseberg C, Lalani T, Gutierrez RL, Tribble DR; TrEAT TD Study Team. Trial Evaluating Ambulatory Therapy of Travelers' Diarrhea (TrEAT TD) Study: A Randomized Controlled Trial Comparing 3 Single-Dose Antibiotic Regimens With Loperamide. Clin Infect Dis. 2017 Nov 29;65(12):2008-2017. doi: 10.1093/cid/cix693.

Reference Type DERIVED
PMID: 29029033 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

IDCRP-065

Identifier Type: -

Identifier Source: org_study_id