Powder Topical Rifampicin on Reducing Infections After Neural Tube Defect Surgery in Infants

NCT ID: NCT03198819

Last Updated: 2017-06-26

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

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-08-31

Study Completion Date

2017-12-31

Brief Summary

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The correct timing and technique of neural tube defect (NTD) repairs significantly decreases the morbidity and mortality of NTD cases. However, infections related to the surgery are still common. We investigated the effects of topical rifampicin (RIF) combined with routine prophylaxis in newborns with open NTD.

Detailed Description

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The study will be conducted in the Yuzuncu Yil University neonatal intensive care unit, Van, Turkey. The data of 60 neonates diagnosed with open NTD, who will be underwent surgical intervention between August 2016 and December 2017, will be prospectively evaluated. These cases will be randomised.These neonates are going to divide into two groups: the experimental group and the control group. The experimental group will be consisted of 30 newborns diagnosed with open NTDs, administered topical RIF (10 mg/kg/day, 24 h infusion) and cefotaxime (50 mg/kg/day, two doses, iv), and the control group will be consisted of 30 newborns diagnosed with open NTDs, administered cefotaxime (50 mg/kg/day, two doses).

In this study, researchers will be investigated whether prophylactic topical RIF applied on a pre-operative mesh in newborns with open NTD reduce the rate of SSIs and meningitis/ VP shunt infections after surgery. For deep incisional primary SSIs will be evaluated according to the diagnostic criteria of the United States (U.S.) Centers for Disease Control and Prevention (CDC) (1). The diagnosis of VP shunt infections will be made after extensive clinical and laboratory evaluations. the diagnosis of to make shunt infections, criteria of the Hydrocephalus Clinical Research Network (HCRN) will be taken into consideration (2).

Topical RIF Application Procedure The NTD site will be covered with a sterile gauze dressing in the first hours of life after birth in all babies with open NTDs. Then, 10 mg/kg/day RIF will be added to 24 ml of saline (0,9% NaCl), and this will be applied to the mesh as an infusion at a 1cc/h speed . Every day, the same dose of RIF will be delivered to the mesh,changed daily, as a 24-hour infusion until the patient could be operated. After the patient is operated, the RIF infusion delivered to the mesh will be stopped. The cefotaxime treatment will be continued until 72 hours post-op (3).

Conditions

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Postoperative Infection Rates

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Rifampisin group

Researchers will administer topical Rifampicin and intravenous cefotaxime

1. For Rifampicin; 10 mg/kg/day, 24 h infusion on defect area during 3 days
2. For cefotaxime; 50 mg/kg/day, twice a day, intravenous during 5 days.

Local Rifampisin and İnrtravenous cefotaxime

Intervention Type DRUG

Control group

Researchers will only administer intravenous cefotaxime

1\) Doses; 50 mg/kg/day, twice a day, intravenous during 5 days.

Local Rifampisin and İnrtravenous cefotaxime

Intervention Type DRUG

Interventions

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Local Rifampisin and İnrtravenous cefotaxime

Intervention Type DRUG

Other Intervention Names

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Only intravenous cefotaxim

Eligibility Criteria

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Inclusion Criteria

* Newborns who have open NTDs

Exclusion Criteria

* Healthy newborns
Minimum Eligible Age

1 Day

Maximum Eligible Age

28 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yuzuncu Yıl University

OTHER

Sponsor Role lead

Responsible Party

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nihat demir

M.D

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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nihat demir

Role: STUDY_DIRECTOR

yüzüncüyıl üniversitesi

Locations

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Yuzuncu yil medical school

Van, Outside of the US, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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ibrahim deger, MD

Role: CONTACT

+905052710158

nihat demir

Role: CONTACT

5326039081

Facility Contacts

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nihat demir

Role: primary

5326039081

References

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Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988 Jun;16(3):128-40. doi: 10.1016/0196-6553(88)90053-3.

Reference Type RESULT
PMID: 2841893 (View on PubMed)

Beckman JM, Amankwah EK, Tetreault LL, Tuite GF. Reduction in CSF shunt infection over a 10-year period associated with the application of concentrated topical antibiotic powder directly to surgical wounds prior to closure. J Neurosurg Pediatr. 2015 Dec;16(6):648-61. doi: 10.3171/2014.12.PEDS13675. Epub 2015 Sep 18.

Reference Type RESULT
PMID: 26382185 (View on PubMed)

Demir N, Peker E, Gulsen I, Kocaman S, Tuncer O, Kirimi E. Powder Topical Rifampin for Reducing Infections After Neural Tube Defect Surgery in Infants. World Neurosurg. 2016 Nov;95:165-170. doi: 10.1016/j.wneu.2016.07.092. Epub 2016 Aug 6.

Reference Type RESULT
PMID: 27506408 (View on PubMed)

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