A Randomized Controlled Trial Comparing Imipenem and Tigecycline Versus Imipenem and Tigecycline With GM-CSF for the Management of Spontaneous Bacterial Peritonitis Presenting With Septic Shock.

NCT ID: NCT04208763

Last Updated: 2021-02-16

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

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-20

Study Completion Date

2021-12-31

Brief Summary

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Study population: A total of 90 consecutive patients of decompensated cirrhosis of any etiology, presenting to the Institute of Liver and Biliary Sciences with SBP with septic shock will be included.

Study design: Randomized controlled trial Study period: August 2019 to December 2021. Sample size: Assuming that the response rate is 90% with GM-CSF and 60% without GM-CSF after day 5. With alpha 5 and power 80,we need to enroll 76 cases (38 cases with each). Further assuming 20 % drop-out due to various reasons, it was decided to enroll 90 cases randomly allocated into two groups (i.e., 45 in each) by block randomization method by taking block size as 6. So for the present study, it was decided to enroll 90 cases in all.

Group A will be given Imipenem and Tigecycline. Patients with recent hospitalisation will be given Colistin in addition.

Group B will be given: To another group we will give Imipenem and Tigecycline and GMCSF.Patients with recent hospitalisation will be given Colistin in addition.

The dose of antibiotic will be given at dosage Inj Imipenem 1gm i.v. TDS Inj Tigecycline 100mg stat f/b 50mg i.v. OD Inj GM-CSF 500mcg s.c. OD Inj Colistin 9 MIU i.v. stat f/b 4.5 MIU i.v. BD Monitoring and assessment At the baseline, all patients will undergo investigational evaluation as described

Daily monitoring of following parameters:

* Haemoglobin,
* Total peripheral leucocyte counts,
* Platelet counts,
* Renal function tests
* Liver function tests and
* Chest X rays will be undertaken
* Ascitic fluid analysis will be done on day 0, day 2 and day 5

Stopping rule:If the patient develops a TLC of more than 50,000, the dose of the GM CSF will be reduced to half and the treatment continued. If, even after the reduction, the TLC rises to more than 50,000, then the treatment will be stopped and the patient excluded.

Expected outcome of the project: Addition of GM-CSF to standard antibiotic regimen helps resolve SBP and improves outcome in decompensated liver cirrhotic patients.

Detailed Description

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Conditions

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Spontaneous 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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Imipenem+Tigecycline+GM-CSF

Group Type EXPERIMENTAL

Imipenem

Intervention Type DRUG

Inj Imipenem 1gm i.v. TDS

Tigecycline

Intervention Type DRUG

Inj Tigecycline 100mg stat f/b 50mg i.v. OD

GMCSF

Intervention Type DRUG

Inj GM-CSF 500mcg s.c. OD

Colistin

Intervention Type DRUG

Inj Colistin 9 MIU i.v. stat f/b 4.5 MIU i.v. BD

Imipenem+Tigecycline

Group Type ACTIVE_COMPARATOR

Imipenem

Intervention Type DRUG

Inj Imipenem 1gm i.v. TDS

Tigecycline

Intervention Type DRUG

Inj Tigecycline 100mg stat f/b 50mg i.v. OD

Colistin

Intervention Type DRUG

Inj Colistin 9 MIU i.v. stat f/b 4.5 MIU i.v. BD

Interventions

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Imipenem

Inj Imipenem 1gm i.v. TDS

Intervention Type DRUG

Tigecycline

Inj Tigecycline 100mg stat f/b 50mg i.v. OD

Intervention Type DRUG

GMCSF

Inj GM-CSF 500mcg s.c. OD

Intervention Type DRUG

Colistin

Inj Colistin 9 MIU i.v. stat f/b 4.5 MIU i.v. BD

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Spontaneous Bacterial Peritonitis (SBP) with shock in a cirrhotic
2. Hospital acquired SBP with shock
3. Difficult to treat SBP

Exclusion Criteria

1. Refractory Shock
2. Cardiac comorbidities (known Coronary Artery Disease)
3. Chronic Kidney Disease on Maintenance Hemodialysis
4. \< 18 years.
5. Advanced Hepatocellular Carcinoma
6. Post liver transplant
7. HIV + ve, Immunosuppressive therapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Liver and Biliary Sciences, India

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Institute of Liver and Biliary Sciences

New Delhi, National Capital Territory of Delhi, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Dr Abhijeet Ranjan, MD

Role: CONTACT

01146300000

Facility Contacts

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Dr Abhijeet Ranjan, MD

Role: primary

01146300000

Other Identifiers

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ILBS-SBP-02

Identifier Type: -

Identifier Source: org_study_id

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