Antibiotic Irrigations for Intra-Abdominal Drains

NCT ID: NCT03476941

Last Updated: 2019-06-06

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-01

Study Completion Date

2021-09-01

Brief Summary

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Intra-abdominal abscesses are pus-filled pouches in the abdominal cavity. Current standard of care includes drain placement in the abscess cavity to reach source control as well as administration of systemic antibiotics. It is common practice to flush the drain on a daily basis to ensure patency. This study aims to analyze the clinical impact of a higher local concentration of antibiotics (rather than normal saline) provided through drain irrigation with an antimicrobial agent (Gentamicin and/or Clindamycin) compare to normal saline.

Detailed Description

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People with an abdominal abscess who undergo drain placement will have those drains irrigated twice/day with either normal saline (placebo group) or with the above antibiotic solution for a total of 7 days or less if the drain were to be removed earlier. Outcomes of interest are duration of systemic antibiotics, and WBC and temperature curve.

Conditions

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Abdominal Abscess

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

There will be two group, study and control group. In control group, patient will receive standard intra-abdominal drain care with daily flushing of the drain with normal saline. In study group, patient will receive daily flush with antibiotic for 7 days.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Written consent will be obtained from all participants. Then, each participant will be randomized into two arms. Nurse will administer the drain flush either with normal saline or antibiotic irrigation.

Study Groups

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Antibiotic Irrigation

The drain will be irrigated twice/day with the above antibiotic solution for 7 days maximum

Group Type EXPERIMENTAL

Gentamicin Sulfate Inj 20mg/2ml vial for injection

Intervention Type DRUG

Irrigate surgical drain with total amount of 5 mg in 10 ml volume twice/day for 7 days or until drain removal if less than 7 days of therapy.

Clindamycin phosphate 6 mg/1ml for injection

Intervention Type DRUG

Irrigate surgical drain with total amount of 12 mg in 10 ml volume once daily for 7 days or until drain removal if less than 7 days of therapy.

Normal Saline Irrigation

The drain will be irrigated twice/day with normal saline

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

The placebo group will receive drain irrigation twice/day

Interventions

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Gentamicin Sulfate Inj 20mg/2ml vial for injection

Irrigate surgical drain with total amount of 5 mg in 10 ml volume twice/day for 7 days or until drain removal if less than 7 days of therapy.

Intervention Type DRUG

Clindamycin phosphate 6 mg/1ml for injection

Irrigate surgical drain with total amount of 12 mg in 10 ml volume once daily for 7 days or until drain removal if less than 7 days of therapy.

Intervention Type DRUG

Placebo

The placebo group will receive drain irrigation twice/day

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Intra-abdominal abscess drained with catheter/drain
* Treatment with systemic antibiotics
* Able to consent

Exclusion Criteria

* Abscess(es) not amendable for an image guided drain placement.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Paolo Goffredo

OTHER

Sponsor Role lead

Responsible Party

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Paolo Goffredo

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Paolo Goffredo, MD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

Locations

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The University of Iowa

Iowa City, Iowa, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Thomas Granchi, MD

Role: CONTACT

319-356-1339

Linda Ahrens

Role: CONTACT

319-353-8435

Facility Contacts

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John Keller

Role: primary

319-335-2123

References

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Yoon YI, Hwang S, Cho YJ, Ha TY, Song GW, Jung DH. Therapeutic effect of trans-drain administration of antibiotics in patients showing intractable pancreatic leak-associated pus drainage after pancreaticoduodenectomy. Korean J Hepatobiliary Pancreat Surg. 2015 Feb;19(1):17-24. doi: 10.14701/kjhbps.2015.19.1.17. Epub 2015 Feb 28.

Reference Type BACKGROUND
PMID: 26155272 (View on PubMed)

Sauermann R, Karch R, Kjellsson MC, Feurstein T, Puspok A, Langenberger H, Bohmdorfer M, Jager W, Zeitlinger M. Good penetration of moxifloxacin into human abscesses. Pharmacology. 2012;90(3-4):146-50. doi: 10.1159/000341550. Epub 2012 Aug 3.

Reference Type BACKGROUND
PMID: 22868236 (View on PubMed)

Sauermann R, Feurstein T, Karch R, Kjellsson MC, Jager W, Bohmdorfer M, Puspok A, Langenberger H, Wild T, Winkler S, Zeitlinger M. Abscess penetration of cefpirome: concentrations and simulated pharmacokinetic profiles in pus. Eur J Clin Pharmacol. 2012 Oct;68(10):1419-23. doi: 10.1007/s00228-012-1270-1. Epub 2012 Mar 23.

Reference Type BACKGROUND
PMID: 22441316 (View on PubMed)

Zimmerman LH, Tyburski JG, Glowniak J, Singla R, Lavery T, Nailor M, Stassinopoulus J, Hong K, Barshikar S, Dolman HS, Baylor AE, Wilson RF. Impact of evaluating antibiotic concentrations in abdominal abscesses percutaneously drained. Am J Surg. 2011 Mar;201(3):348-52; discussion 352. doi: 10.1016/j.amjsurg.2010.09.010.

Reference Type BACKGROUND
PMID: 21367377 (View on PubMed)

Other Identifiers

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201703759

Identifier Type: -

Identifier Source: org_study_id

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