Efficacy of Temocillin in Urinary Tract Infection Due to ESBL Producing and AmpC Hyperproducing Enterobacteriaceae

NCT ID: NCT02681263

Last Updated: 2018-06-06

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

PHASE4

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-04-30

Study Completion Date

2018-09-30

Brief Summary

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The present study aims at demonstrating the efficacy of temocillin in the treatment of UTI requiring parenteral therapy due to a confirmed ESBL producing or AmpC hyperproducing Enterobacteriaceae, resistant to quinolones and Bactrim® in France. In addition, this study will describe and support the use of high dose (6g/day) of temocillin which could be of interest for the treatment urinary tract infection due to multi-resistant bacteria having high MIC (up to 32 mg/L). The investigators will also evaluate the tolerance of the drug by monitoring the adverse event and the incidence of eventual Clostridium difficile associated infection.

Detailed Description

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Conditions

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Urinary Tract Infections

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Temocillin

Treatment duration with a minimum of 5 days administration of the study drug: Temocillin (Negaban®) 6g/day (2g/tid) and as monotherapy.

Total antibiotic treatment between 10 and 14 days according to local guidelines (up to 21 days in immunosuppressed patients).

Group Type EXPERIMENTAL

Temocillin

Intervention Type DRUG

Treatment duration with a minimum of 5 days administration of the study drug: Temocillin (Negaban®) 6g/day (2g/tid) and as monotherapy.

Interventions

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Temocillin

Treatment duration with a minimum of 5 days administration of the study drug: Temocillin (Negaban®) 6g/day (2g/tid) and as monotherapy.

Intervention Type DRUG

Other Intervention Names

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NEGABAN

Eligibility Criteria

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Inclusion Criteria

* Age of at least 18 year old
* Patient benefits from social security
* Signed informed consent
* A urinary tract infection due to a confirmed ESBL producing strain (detected by the use of a rapid diagnostic test applied on the urine) requiring parenteral antimicrobial therapy
* Hospitalized patient
* For women able to procreate: Use of an acceptable method of birth control throughout the study. Acceptable methods of birth control are: oral contraceptives, intrauterine device (IUD), diaphragm with spermicide and condom. (All forms of hormonal contraception are acceptable

Exclusion Criteria

* Patient infected with a bacteria which is not an ESBL-producing or AmpC hyperproducing Enterobacteriaceae
* Patients infected with a strain sensible to both fluoroquinolones and trimethoprim/sulfamethoxazole
* Patients infected with a strain resistant to temocillin
* Hospital-acquired urinary tract infection (defined as a urinary infection that occurred at least 48h post admission in the hospital)
* Patients has received any dose of active antimicrobial therapy (an antibiotic to which the infecting bacterium is susceptible) in the last 48h (prior to enrolment) except ≤ 2 dose of gentamicin.
* Patients presenting another site of infection than urinary (except onset of bacteraemia from urinary tract origin) due to Gram negative bacteria.
* Patients needing concomitant antimicrobial therapy.
* Septic shock
* Children (up to 18 years old)
* Women who is pregnant, breastfeeding, or expecting to conceive at any time during the study (pregnancy test will be conducted for woman without menopause)
* Patients with any kind of urinary/bladder catheter (JJ ureteral probe, …)
* Hypersensitivity to the active substance, to penicillins or to any other type of beta-lactam agent
* Chronically dialyzed patients
* Patients having a creatinine clearance \< 30 mL/min
* Complete obstruction of the urinary tract
* Perinephretic or intrarenal abscesses
* Tutorship or curatorship patient
* Patient unable to give his consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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French National Network of Clinical Research in Infectious Diseases (RENARCI)

OTHER

Sponsor Role collaborator

University Hospital, Grenoble

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean Paul STAHL, PU-PH

Role: STUDY_CHAIR

University Hospital, Grenoble

Locations

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CH Ajaccio

Ajaccio, , France

Site Status

CH Annecy Genevois

Annecy, , France

Site Status

APHP - Avicenne Hospital

Bobigny, , France

Site Status

APHP - Beaujon Hospital

Clichy, , France

Site Status

CHU de Martinique

Fort de France, , France

Site Status

CHU de Grenoble

Grenoble, , France

Site Status

APHP - Bicêtre Hospital

Le Kremlin-Bicêtre, , France

Site Status

CHU de Lille

Lille, , France

Site Status

CHU de Nantes

Nantes, , France

Site Status

CHU de Nice

Nice, , France

Site Status

APHP - Bichat Hospital

Paris, , France

Site Status

APHP - Cochin Hospital

Paris, , France

Site Status

APHP - St Louis

Paris, , France

Site Status

CH de Perpignan

Perpignan, , France

Site Status

CHU de Pointe à Pitre

Pointe à Pitre, , France

Site Status

CHU de Poitiers

Poitiers, , France

Site Status

CHU de Rouen

Rouen, , France

Site Status

CHU de Saint Etienne

Saint-Etienne, , France

Site Status

CHU de Tours

Tours, , France

Site Status

Countries

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France

References

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Laterre PF, Wittebole X, Van de Velde S, Muller AE, Mouton JW, Carryn S, Tulkens PM, Dugernier T. Temocillin (6 g daily) in critically ill patients: continuous infusion versus three times daily administration. J Antimicrob Chemother. 2015 Mar;70(3):891-8. doi: 10.1093/jac/dku465. Epub 2014 Nov 27.

Reference Type BACKGROUND
PMID: 25433006 (View on PubMed)

Balakrishnan I, Awad-El-Kariem FM, Aali A, Kumari P, Mulla R, Tan B, Brudney D, Ladenheim D, Ghazy A, Khan I, Virgincar N, Iyer S, Carryn S, Van de Velde S. Temocillin use in England: clinical and microbiological efficacies in infections caused by extended-spectrum and/or derepressed AmpC beta-lactamase-producing Enterobacteriaceae. J Antimicrob Chemother. 2011 Nov;66(11):2628-31. doi: 10.1093/jac/dkr317. Epub 2011 Aug 2.

Reference Type BACKGROUND
PMID: 21810837 (View on PubMed)

Fournier D, Chirouze C, Leroy J, Cholley P, Talon D, Plesiat P, Bertrand X. Alternatives to carbapenems in ESBL-producing Escherichia coli infections. Med Mal Infect. 2013 Feb;43(2):62-6. doi: 10.1016/j.medmal.2013.01.006. Epub 2013 Feb 19.

Reference Type BACKGROUND
PMID: 23433608 (View on PubMed)

Schulze B, Heilmann HD. Treatment of severe infections with temocillin. Clinical and bacteriological evaluation. Drugs. 1985;29 Suppl 5:207-9. doi: 10.2165/00003495-198500295-00046.

Reference Type BACKGROUND
PMID: 4029026 (View on PubMed)

De Jongh R, Hens R, Basma V, Mouton JW, Tulkens PM, Carryn S. Continuous versus intermittent infusion of temocillin, a directed spectrum penicillin for intensive care patients with nosocomial pneumonia: stability, compatibility, population pharmacokinetic studies and breakpoint selection. J Antimicrob Chemother. 2008 Feb;61(2):382-8. doi: 10.1093/jac/dkm467. Epub 2007 Dec 10.

Reference Type BACKGROUND
PMID: 18070831 (View on PubMed)

Other Identifiers

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2015-004178-14

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

38RC15.213

Identifier Type: -

Identifier Source: org_study_id

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