Trial Outcomes & Findings for Gentamicin Intravesical Efficacy for Infection of Urinary Tract (NCT NCT04246996)

NCT ID: NCT04246996

Last Updated: 2022-11-08

Results Overview

Number of participants in each arm treated with antibiotics for urinary tract infection symptoms

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

370 participants

Primary outcome timeframe

Within 6 weeks after surgery

Results posted on

2022-11-08

Participant Flow

Participant milestones

Participant milestones
Measure
Gentamicin Arm
At completion of surgery but prior to awakening from anesthesia, after ensuring the bladder is fully drained, 80mg of gentamicin in 50 mL of normal saline will be infused by the surgeon into the participants's bladder through the standard-care transurethral catheter. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The participant will then proceed as usual to the postoperative anesthesia care unit. The recovery room nurse will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
At the end of the surgery but prior to awakening from anesthesia, after ensuring the bladder is fully drained, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for participants receiving usual care will be to ensure participants are masked to study arm assignment if they wake up and notice their catheter. The participant will then proceed as usual to the postoperative anesthesia care unit. The recovery room nurse will unclamp the catheter after 1 hour. The participant will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Participants in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain participant masking to study arm.
Overall Study
STARTED
185
185
Overall Study
COMPLETED
183
180
Overall Study
NOT COMPLETED
2
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Gentamicin Arm
At completion of surgery but prior to awakening from anesthesia, after ensuring the bladder is fully drained, 80mg of gentamicin in 50 mL of normal saline will be infused by the surgeon into the participants's bladder through the standard-care transurethral catheter. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The participant will then proceed as usual to the postoperative anesthesia care unit. The recovery room nurse will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
At the end of the surgery but prior to awakening from anesthesia, after ensuring the bladder is fully drained, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for participants receiving usual care will be to ensure participants are masked to study arm assignment if they wake up and notice their catheter. The participant will then proceed as usual to the postoperative anesthesia care unit. The recovery room nurse will unclamp the catheter after 1 hour. The participant will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Participants in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain participant masking to study arm.
Overall Study
Physician Decision
1
1
Overall Study
Did not meet eligibility criteria
1
4

Baseline Characteristics

Gentamicin Intravesical Efficacy for Infection of Urinary Tract

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Gentamicin Arm
n=183 Participants
At the completion of the subjects surgery but prior to awakening from anesthesia, 80mg of gentamicin in 50 mL of normal saline will be infused into the subject's bladder through the standard-of-care transurethral catheter by the surgeon. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
n=180 Participants
If the patient is randomized to no instillation, at the end of the surgery but prior to awakening from anesthesia, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for subjects receiving usual care will be to ensure patients are masked to study arm assignment if they wake up and notice their catheter. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Subjects in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain subject masking to study arm.
Total
n=363 Participants
Total of all reporting groups
Age, Continuous
58.5 years
STANDARD_DEVIATION 12.0 • n=5 Participants
58.7 years
STANDARD_DEVIATION 12.8 • n=7 Participants
58.6 years
STANDARD_DEVIATION 12.4 • n=5 Participants
Sex: Female, Male
Female
183 Participants
n=5 Participants
180 Participants
n=7 Participants
363 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
6 Participants
n=5 Participants
5 Participants
n=7 Participants
11 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
70 Participants
n=5 Participants
61 Participants
n=7 Participants
131 Participants
n=5 Participants
Race/Ethnicity, Customized
White Non-Hispanic
97 Participants
n=5 Participants
99 Participants
n=7 Participants
196 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
4 Participants
n=5 Participants
8 Participants
n=7 Participants
12 Participants
n=5 Participants
Race/Ethnicity, Customized
Not specified
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Region of Enrollment
United States
183 participants
n=5 Participants
180 participants
n=7 Participants
363 participants
n=5 Participants
Study site
University of California San Diego
122 Participants
n=5 Participants
123 Participants
n=7 Participants
245 Participants
n=5 Participants
Study site
Kaiser Permanente San Diego
61 Participants
n=5 Participants
57 Participants
n=7 Participants
118 Participants
n=5 Participants
Body mass index
28.5 kg/m^2
STANDARD_DEVIATION 5.6 • n=5 Participants
28.2 kg/m^2
STANDARD_DEVIATION 5.1 • n=7 Participants
28.2 kg/m^2
STANDARD_DEVIATION 5.1 • n=5 Participants
Parity
2 births
n=5 Participants
2 births
n=7 Participants
2 births
n=5 Participants
American Society of Anesthesiologists (ASA) Physical Status Classification
2 units on a scale
n=5 Participants
2 units on a scale
n=7 Participants
2 units on a scale
n=5 Participants
Diabetes mellitus
24 Participants
n=5 Participants
25 Participants
n=7 Participants
49 Participants
n=5 Participants
Current smoker
9 Participants
n=5 Participants
12 Participants
n=7 Participants
21 Participants
n=5 Participants
Postmenopausal
Yes
122 Participants
n=5 Participants
116 Participants
n=7 Participants
238 Participants
n=5 Participants
Postmenopausal
No
47 Participants
n=5 Participants
48 Participants
n=7 Participants
95 Participants
n=5 Participants
Postmenopausal
Unknown
14 Participants
n=5 Participants
16 Participants
n=7 Participants
30 Participants
n=5 Participants
Current vaginal estrogen use
79 Participants
n=5 Participants
76 Participants
n=7 Participants
155 Participants
n=5 Participants
Current menopausal hormone therapy use
10 Participants
n=5 Participants
9 Participants
n=7 Participants
19 Participants
n=5 Participants
Number of culture positive UTIs in 12 months prior to surgery
0 UTIs
155 participants
n=5 Participants
156 participants
n=7 Participants
311 participants
n=5 Participants
Number of culture positive UTIs in 12 months prior to surgery
1 UTI
20 participants
n=5 Participants
20 participants
n=7 Participants
40 participants
n=5 Participants
Number of culture positive UTIs in 12 months prior to surgery
2 UTIs
6 participants
n=5 Participants
3 participants
n=7 Participants
9 participants
n=5 Participants
Number of culture positive UTIs in 12 months prior to surgery
3 UTIs
2 participants
n=5 Participants
1 participants
n=7 Participants
3 participants
n=5 Participants
Positive urine culture within 4 weeks before surgery
6 Participants
n=5 Participants
4 Participants
n=7 Participants
10 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Within 6 weeks after surgery

Number of participants in each arm treated with antibiotics for urinary tract infection symptoms

Outcome measures

Outcome measures
Measure
Gentamicin Arm
n=183 Participants
At the completion of the subjects surgery but prior to awakening from anesthesia, 80mg of gentamicin in 50 mL of normal saline will be infused into the subject's bladder through the standard-of-care transurethral catheter by the surgeon. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
n=180 Participants
If the patient is randomized to no instillation, at the end of the surgery but prior to awakening from anesthesia, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for subjects receiving usual care will be to ensure patients are masked to study arm assignment if they wake up and notice their catheter. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Subjects in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain subject masking to study arm.
Post-operative Urinary Tract Infection
19 Participants
20 Participants

SECONDARY outcome

Timeframe: Within 6 weeks after surgery

Hospital readmissions

Outcome measures

Outcome measures
Measure
Gentamicin Arm
n=183 Participants
At the completion of the subjects surgery but prior to awakening from anesthesia, 80mg of gentamicin in 50 mL of normal saline will be infused into the subject's bladder through the standard-of-care transurethral catheter by the surgeon. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
n=180 Participants
If the patient is randomized to no instillation, at the end of the surgery but prior to awakening from anesthesia, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for subjects receiving usual care will be to ensure patients are masked to study arm assignment if they wake up and notice their catheter. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Subjects in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain subject masking to study arm.
Adverse Events
5 Participants
6 Participants

SECONDARY outcome

Timeframe: Within 6 weeks after surgery

Outcome measures

Outcome measures
Measure
Gentamicin Arm
n=183 Participants
At the completion of the subjects surgery but prior to awakening from anesthesia, 80mg of gentamicin in 50 mL of normal saline will be infused into the subject's bladder through the standard-of-care transurethral catheter by the surgeon. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
n=180 Participants
If the patient is randomized to no instillation, at the end of the surgery but prior to awakening from anesthesia, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for subjects receiving usual care will be to ensure patients are masked to study arm assignment if they wake up and notice their catheter. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Subjects in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain subject masking to study arm.
Number of Participants With Isolated Uropathogen on Post-operative Urine Culture
12 Participants
15 Participants

Adverse Events

Gentamicin Arm

Serious events: 5 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Arm

Serious events: 6 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Gentamicin Arm
n=183 participants at risk
At the completion of the subjects surgery but prior to awakening from anesthesia, 80mg of gentamicin in 50 mL of normal saline will be infused into the subject's bladder through the standard-of-care transurethral catheter by the surgeon. The surgeon will then clamp the catheter and label the catheter with the clamping time. The catheter will be clamped to prevent the gentamicin from immediately flowing out of the bladder and thus allow the gentamicin time to have an effect. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. gentamicin sulfate: Subjects in the gentamicin arm will receive an bladder instillation of 80mg of gentamicin sulfate in 50 mL of normal saline through a standard-of-care Foley catheter.
Control Arm
n=180 participants at risk
If the patient is randomized to no instillation, at the end of the surgery but prior to awakening from anesthesia, the surgeon will clamp the catheter and label the catheter with the clamping time. The purpose of clamping the catheter for subjects receiving usual care will be to ensure patients are masked to study arm assignment if they wake up and notice their catheter. The subject will then proceed as usual to the postoperative anesthesia care unit. A member of the subject's care team will unclamp the catheter after 1 hour. The subject will otherwise have usual pre-operative and post-operative care. Catheter clamping only: Subjects in the control arm will have their standard-of-care transurethral catheter clamped for 1 hour post-placement to maintain subject masking to study arm.
Gastrointestinal disorders
Small bowel obstruction
0.00%
0/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.56%
1/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Surgical and medical procedures
Reoperation for hematoma
0.55%
1/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.00%
0/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Infections and infestations
Pelvic abscess
0.55%
1/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.00%
0/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Nervous system disorders
Ischemic stroke
0.00%
0/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.56%
1/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Endocrine disorders
Diabetic Ketoacidosis
0.00%
0/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.56%
1/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Injury, poisoning and procedural complications
Uncontrolled postoperative pain
0.55%
1/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.00%
0/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Gastrointestinal disorders
Acute cholecystitis
0.55%
1/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.00%
0/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Surgical and medical procedures
Admitted for planned breast surgery
0.55%
1/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.00%
0/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Renal and urinary disorders
Reoperation for sling division
0.00%
0/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.56%
1/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Respiratory, thoracic and mediastinal disorders
Aspiration pneumonia
0.00%
0/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.56%
1/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
Gastrointestinal disorders
Ileus
0.00%
0/183 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record
0.56%
1/180 • 6 weeks after surgery
Hospital readmission within 6 weeks after surgery as reported by patient or found in electronic medical record

Other adverse events

Adverse event data not reported

Additional Information

Mary Rieger, MD, MAS

Dell Medical School at The University of Texas at Austin

Phone: 512-324-7036

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place