Is Spontaneous Bacterial Peritonitis Still Responding to 3rd Generation Cephalosporins?

NCT ID: NCT02443285

Last Updated: 2017-06-20

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-01-31

Study Completion Date

2019-12-31

Brief Summary

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Current European and most other international guidelines recommend the use of a third-generation cephalosporin as the first choice, or amoxicillin-clavulanate acid or fluoroquinolones as an alternative choice .

These recommendations are based mainly on clinical trials that were very often conducted a decade or more ago, and on the assumption that E. coli would be involved in nearly half of the cases.

The microbial etiology of SBP remains relatively constant; however, the antibiotic resistance rate especially for third-generation cephalosporins (including cefotaxime and ceftazidime), ciprofloxacin, and ofloxacin increased dramatically .

Detailed Description

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Spontaneous bacterial peritonitis (SBP), defined as an infection of ascites in the absence of a contiguous source of infection.

Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal bacterial infection in patients with cirrhosis and ascites, occurring in 10 to 30% of patients, with in-hospital mortality rates ranging from 20 to 30% .

It is secondary to impaired humoral and cellular immune responses that result in indirect intestinal bacterial translocation into the ascitic fluid .

SBP is also associated with a poor long-term prognosis for patients, as mortality rates can reach 50 to 70% at 1 year .

Early diagnosis and early optimal treatment of these infections with appropriate antibiotics and the prevention of hepatorenal syndrome with albumin are required .

Current European and most other international guidelines recommend the use of a third-generation cephalosporin as the first choice, or amoxicillin-clavulanate acid or fluoroquinolones as an alternative choice.

These recommendations are based mainly on clinical trials that were very often conducted a decade or more ago, and on the assumption that E. coli would be involved in nearly half of the cases.

The microbial etiology of SBP remains relatively constant; however, the antibiotic resistance rate especially for third-generation cephalosporins (including cefotaxime and ceftazidime), ciprofloxacin, and ofloxacin increased dramatically.

Conditions

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Primary Bacterial Peritonitis

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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Cefotaxime

cefotaxime 2gm every 12 hours daily for 5 days

Group Type ACTIVE_COMPARATOR

Cefotaxime

Intervention Type DRUG

Cefotaxime 2 gram every12 hours for 5 days

Ceftriaxone

ceftriaxone 2 gm every 24 hours for 5 days.

Group Type ACTIVE_COMPARATOR

ceftriaxone

Intervention Type DRUG

Ceftriaxone 2 gm every 24 hours for 5 days

Interventions

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Cefotaxime

Cefotaxime 2 gram every12 hours for 5 days

Intervention Type DRUG

ceftriaxone

Ceftriaxone 2 gm every 24 hours for 5 days

Intervention Type DRUG

Other Intervention Names

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claforan, cefotax rocephin, cefaxone

Eligibility Criteria

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Inclusion Criteria

* Liver cirrhosis with ascites and SBP

Exclusion Criteria

* ascitic fluid with polymicrobial infections
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Sherief Abd-Elsalam

PI

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sherief M Abd-elsalam, lecturer

Role: PRINCIPAL_INVESTIGATOR

hepatology dept-Tanta

Hanan H Soliman, Professor

Role: STUDY_DIRECTOR

hepatology dept-Tanta

Walaa A Elkhalawany, lecturer

Role: STUDY_CHAIR

hepatology dept-Tanta

Locations

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Tanta university - faculty of medicine

Cairo, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Sherief M Abd-elsalam

Role: CONTACT

00201095159522

Sherief M Abd-elsalam, lecturer

Role: CONTACT

01095159522

Facility Contacts

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Sherief M Abdelsalam, lecturer

Role: primary

00201095159522

Other Identifiers

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SBP TREATMENT

Identifier Type: -

Identifier Source: org_study_id

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