Does Cefoxitin or Piperacillin-Tazobactam Prevent Postoperative Surgical Site Infections After Pancreatoduodenectomy?

NCT ID: NCT03269994

Last Updated: 2025-10-21

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

967 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-21

Study Completion Date

2025-01-28

Brief Summary

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The purpose of this study is to figure out which commonly used antibiotic, cefoxitin or piperacillin-tazobactam, is better at decreasing the rate of surgical site infections after pancreatoduodenectomy.

Detailed Description

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Conditions

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Pancreatic Cancer Pancreas Cancer Pancreatic Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cefoxitin

Group Type ACTIVE_COMPARATOR

Cefoxitin

Intervention Type DRUG

Participants will receive one dose of cefoxitin within 1 hour of incision time, redosed every 2-4 hours in the operating room until closure of the incision, and discontinued within 24 hours after anesthesia end time.

Piperacillin-tazobactam

Group Type EXPERIMENTAL

Piperacillin-tazobactam

Intervention Type DRUG

Participants will receive one dose of piperacillin-tazobactam within 1 hour of incision time, redosed every 2-4 hours in the operating room until closure of the incision, and discontinued within 24 hours after anesthesia end time.

Interventions

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Cefoxitin

Participants will receive one dose of cefoxitin within 1 hour of incision time, redosed every 2-4 hours in the operating room until closure of the incision, and discontinued within 24 hours after anesthesia end time.

Intervention Type DRUG

Piperacillin-tazobactam

Participants will receive one dose of piperacillin-tazobactam within 1 hour of incision time, redosed every 2-4 hours in the operating room until closure of the incision, and discontinued within 24 hours after anesthesia end time.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age \>/= 18 years
* Patients undergoing elective pancreatoduodenectomy (PD) for any diagnosis/indication

Exclusion Criteria

* Patients undergoing a minimally invasive PD, such as laparoscopic or robotic PD
* Patients with known and documented allergies to any of the penicillins, cephalosporins, or β-lactamase inhibitors
* Patients who are otherwise ineligible to receive the antibiotics in this study
* Patients highly unlikely to undergo PD according to the surgeon's judgment, such as conditions amenable to pancreas enucleation, ampullectomy, etc.
* Patients with long-term glucocorticosteroid use. The following uses of corticosteroids are permitted: single doses, topical applications (e.g., for rash), inhaled sprays (e.g., for obstructive airways diseases), eye drops or local injections (e.g., intra-articular)
* Patients unable to provide informed consent
* Creatinine clearance (CrCl) \</= 40 mL/min
* Patients receiving hemodialysis or peritoneal dialysis
* Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test
* Patients with a known bacterial infection present at the time of surgery or who received antimicrobial therapy within 7 days prior to surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Indiana University

OTHER

Sponsor Role collaborator

Massachusetts General Hospital

OTHER

Sponsor Role collaborator

Thomas Jefferson University

OTHER

Sponsor Role collaborator

Washington University School of Medicine

OTHER

Sponsor Role collaborator

Advocate Illinois Masonic Medical Center

OTHER

Sponsor Role collaborator

Baptist Memorial Health Care Corporation

OTHER

Sponsor Role collaborator

Baylor Scott and White Health

OTHER

Sponsor Role collaborator

The Cleveland Clinic

OTHER

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role collaborator

Fox Chase Cancer Center

OTHER

Sponsor Role collaborator

Gundersen Lutheran Medical Center

UNKNOWN

Sponsor Role collaborator

Hackensack Meridian Health

OTHER

Sponsor Role collaborator

Hamilton Health Sciences Center

UNKNOWN

Sponsor Role collaborator

Intermountain Health Care, Inc.

OTHER

Sponsor Role collaborator

Jersey Shore Medical Center (Hackensack Meridian)

UNKNOWN

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role collaborator

Montefiore Medical Center/Albert Einstein College of Medicine

UNKNOWN

Sponsor Role collaborator

North Shore University HealthSystem

UNKNOWN

Sponsor Role collaborator

Milton S. Hershey Medical Center

OTHER

Sponsor Role collaborator

Rhode Island Hospital

OTHER

Sponsor Role collaborator

Stony Brook Medicine

UNKNOWN

Sponsor Role collaborator

Sunnybrook Health Sciences Centre, Canada

UNKNOWN

Sponsor Role collaborator

Temple University

OTHER

Sponsor Role collaborator

Ohio State University

OTHER

Sponsor Role collaborator

The Ottowa Hospital/University of Ottowa

UNKNOWN

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role collaborator

University of Chicago

OTHER

Sponsor Role collaborator

University of Iowa

OTHER

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role collaborator

Providence Health & Services

OTHER

Sponsor Role collaborator

Albany Medical College

OTHER

Sponsor Role collaborator

Northwestern University

OTHER

Sponsor Role collaborator

Universtiy of Mississippi Medical Center

UNKNOWN

Sponsor Role collaborator

Mount Sinai Hospital, New York

OTHER

Sponsor Role collaborator

Brody School of Medicine at East Carolina University

UNKNOWN

Sponsor Role collaborator

Memorial Sloan Kettering Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael D'Angelica, MD

Role: PRINCIPAL_INVESTIGATOR

Memorial Sloan Kettering Cancer Center

Locations

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UC Davis Comprehensive Cancer Center

Sacramento, California, United States

Site Status

Emory University School of Medicine

Atlanta, Georgia, United States

Site Status

Northwestern Medicine (Data Collection)

Chicago, Illinois, United States

Site Status

NorthShore University Health System

Evanston, Illinois, United States

Site Status

Indiana University

Indianapolis, Indiana, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

University of Washington School of Medicine

St Louis, Missouri, United States

Site Status

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Memorial Sloan Kettering Basking Ridge (Consent only)

Basking Ridge, New Jersey, United States

Site Status

Hackensack Meridian Health / Hackensack University Medical Center Cancer Center

Hackensack, New Jersey, United States

Site Status

Memorial Sloan Kettering Commack (Consent only)

Commack, New York, United States

Site Status

Memoral Sloan Kettering Westchester (Consent only)

Harrison, New York, United States

Site Status

Mount Sinai Hospital

New York, New York, United States

Site Status

Mount Sinai West

New York, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

Montefiore Health Systems (Montefiore Medical Center)

The Bronx, New York, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

Brody School of Medicine at East Carolina University

Greenville, North Carolina, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

Providence Health & Services (Portland Med Ctr)

Portland, Oregon, United States

Site Status

Pennsylvania State Hershey

Hershey, Pennsylvania, United States

Site Status

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Baptist Memorial Healthcare

Memphis, Tennessee, United States

Site Status

Baylor Scott & White Health

Dallas, Texas, United States

Site Status

Intermountain Healthcare

Murray, Utah, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

Gundersen Lutheran Medical Foundation

La Crosse, Wisconsin, United States

Site Status

University of Wisconsin

Madison, Wisconsin, United States

Site Status

Hamilton Health Sciences Center (Juravinski Hospital)

Hamilton, Ontario, Canada

Site Status

Ottawa Hospital

Ottawa, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

References

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D'Angelica MI, Ellis RJ, Liu JB, Brajcich BC, Gonen M, Thompson VM, Cohen ME, Seo SK, Zabor EC, Babicky ML, Bentrem DJ, Behrman SW, Bertens KA, Celinski SA, Chan CHF, Dillhoff M, Dixon MEB, Fernandez-Del Castillo C, Gholami S, House MG, Karanicolas PJ, Lavu H, Maithel SK, McAuliffe JC, Ott MJ, Reames BN, Sanford DE, Sarpel U, Scaife CL, Serrano PE, Smith T, Snyder RA, Talamonti MS, Weber SM, Yopp AC, Pitt HA, Ko CY. Piperacillin-Tazobactam Compared With Cefoxitin as Antimicrobial Prophylaxis for Pancreatoduodenectomy: A Randomized Clinical Trial. JAMA. 2023 May 9;329(18):1579-1588. doi: 10.1001/jama.2023.5728.

Reference Type DERIVED
PMID: 37078771 (View on PubMed)

Nevarez NM, Brajcich BC, Liu J, Ellis R, Ko CY, Pitt HA, D'Angelica MI, Yopp AC. Cefoxitin versus piperacillin-tazobactam as surgical antibiotic prophylaxis in patients undergoing pancreatoduodenectomy: protocol for a randomised controlled trial. BMJ Open. 2021 Mar 4;11(3):e048398. doi: 10.1136/bmjopen-2020-048398.

Reference Type DERIVED
PMID: 33664081 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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http://www.mskcc.org

Memorial Sloan Kettering Cancer Center

Other Identifiers

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17-418

Identifier Type: -

Identifier Source: org_study_id

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