Community-Acquired Pneumonia - Study on the Initial Treatment With Antibiotics of Lower Respiratory Tract Infections

NCT ID: NCT01660204

Last Updated: 2014-04-23

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

NA

Total Enrollment

2283 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-02-28

Study Completion Date

2014-01-31

Brief Summary

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The purpose of this study is to compare the cost(effectiveness) of three existing antibiotic strategies for patients with community-acquired pneumonia admitted to the hospital, but not the ICU.

Detailed Description

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Conditions

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Community-acquired Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Betalactam monotherapy

Preferred empirical treatment for patients in this arm is Beta-lactam monotherapy e.g. co-amoxiclav or ceftriaxone

Group Type ACTIVE_COMPARATOR

Preferred empirical treatment

Intervention Type OTHER

The investigators are using a cluster-randomized cross-over design for preferred empirical treatment. One of the 3 treatment arms is used as preferred empirical therapy during a period of 4 consecutive months, after which preferred treatment will rotate to 1 of the other 2 regimens. The order of change is randomised per hospital, thereby controlling for inter-hospital variables and minimizing seasonal influences.

Betalactam combination with macrolide

Preferred empirical treatment for patients in this arm is beta-lactam combination therapy with a macrolide e.g. ceftriaxone and erythromycin

Group Type ACTIVE_COMPARATOR

Preferred empirical treatment

Intervention Type OTHER

The investigators are using a cluster-randomized cross-over design for preferred empirical treatment. One of the 3 treatment arms is used as preferred empirical therapy during a period of 4 consecutive months, after which preferred treatment will rotate to 1 of the other 2 regimens. The order of change is randomised per hospital, thereby controlling for inter-hospital variables and minimizing seasonal influences.

Quinolone monotherapy

Preferred empirical treatment for patients in this arm is quinolone monotherapy e.g. moxifloxacin or levofloxacin

Group Type ACTIVE_COMPARATOR

Preferred empirical treatment

Intervention Type OTHER

The investigators are using a cluster-randomized cross-over design for preferred empirical treatment. One of the 3 treatment arms is used as preferred empirical therapy during a period of 4 consecutive months, after which preferred treatment will rotate to 1 of the other 2 regimens. The order of change is randomised per hospital, thereby controlling for inter-hospital variables and minimizing seasonal influences.

Interventions

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Preferred empirical treatment

The investigators are using a cluster-randomized cross-over design for preferred empirical treatment. One of the 3 treatment arms is used as preferred empirical therapy during a period of 4 consecutive months, after which preferred treatment will rotate to 1 of the other 2 regimens. The order of change is randomised per hospital, thereby controlling for inter-hospital variables and minimizing seasonal influences.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All patients admitted to one of the participating hospitals needing treatment for CAP, not being admitted to the ICU are eligible for study inclusion.
* Admission is defined as hospital stay for more than 24 hours.

Exclusion Criteria

* Patients who are readmitted with CAP within 2 weeks after a previous episode are not eligible.
* Patients with cystic fibrosis are not eligible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ZonMw: The Netherlands Organisation for Health Research and Development

OTHER

Sponsor Role collaborator

UMC Utrecht

OTHER

Sponsor Role lead

Responsible Party

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MJM Bonten

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marc J. Bonten, MD PhD

Role: PRINCIPAL_INVESTIGATOR

UMC Utrecht

Locations

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Medical Center Alkmaar

Alkmaar, , Netherlands

Site Status

AMC Amsterdam

Amsterdam, , Netherlands

Site Status

Amphia Hospital Breda

Breda, , Netherlands

Site Status

Kennemer Gasthuis

Haarlem, , Netherlands

Site Status

Spaarne Hospital

Hoofddorp, , Netherlands

Site Status

Diakonessenhuis Utrecht

Utrecht, , Netherlands

Site Status

UMC Utrecht

Utrecht, , Netherlands

Site Status

Countries

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Netherlands

References

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Postma DF, Spitoni C, van Werkhoven CH, van Elden LJR, Oosterheert JJ, Bonten MJM. Cardiac events after macrolides or fluoroquinolones in patients hospitalized for community-acquired pneumonia: post-hoc analysis of a cluster-randomized trial. BMC Infect Dis. 2019 Jan 7;19(1):17. doi: 10.1186/s12879-018-3630-7.

Reference Type DERIVED
PMID: 30612559 (View on PubMed)

van Werkhoven CH, Postma DF, Mangen MJ, Oosterheert JJ, Bonten MJ; CAP-START study group. Cost-effectiveness of antibiotic treatment strategies for community-acquired pneumonia: results from a cluster randomized cross-over trial. BMC Infect Dis. 2017 Jan 10;17(1):52. doi: 10.1186/s12879-016-2179-6.

Reference Type DERIVED
PMID: 28068956 (View on PubMed)

Postma DF, van Werkhoven CH, van Elden LJ, Thijsen SF, Hoepelman AI, Kluytmans JA, Boersma WG, Compaijen CJ, van der Wall E, Prins JM, Oosterheert JJ, Bonten MJ; CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med. 2015 Apr 2;372(14):1312-23. doi: 10.1056/NEJMoa1406330.

Reference Type DERIVED
PMID: 25830421 (View on PubMed)

van Werkhoven CH, Postma DF, Oosterheert JJ, Bonten MJ. Antibiotic treatment of moderate-severe community-acquired pneumonia: design and rationale of a multicentre cluster-randomised cross-over trial. Neth J Med. 2014 Apr;72(3):170-8.

Reference Type DERIVED
PMID: 24846935 (View on PubMed)

Other Identifiers

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80-82310-97-12044

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

10-148

Identifier Type: -

Identifier Source: org_study_id

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