Rifabutin Versus Rifampicin for Treatment of Staphylococcal PJI Treated With DAIR

NCT ID: NCT04672525

Last Updated: 2022-05-10

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

PHASE3

Total Enrollment

436 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-08

Study Completion Date

2027-06-30

Brief Summary

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Rifampicin, is key in the treatment of staphylococcal PJIs. Rifabutin has a better profile of tolerance than rifampicin regarding the risk of interaction with concomitant medications and liver disorders. The hypothesis is that rifabutin may be an alternative antibiotic option as efficient as rifampicin for the treatment of staphylococcal PJIs, with a better safety profile. The investigator aim to demonstrate the non-inferiority of rifabutin as compared with rifampicin prescribed in combination treatment for PJIs.

Detailed Description

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Conditions

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Prosthetic Infection

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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RIFAMPICIN

Patient with staphylococcal PJI, treated with DAIR strategy, and randomized in the control group will receive rifampicin in association with another antibiotic except rifabutin, as-per recommendations for 12 weeks.

Group Type ACTIVE_COMPARATOR

Rifampicin

Intervention Type DRUG

10 mg/kg per day (range 600 mg to 1,200 mg) rifampicin tablet in 1 daily dose for 12 weeks with a companion treatment

RIFABUTIN

Patient with staphylococcal PJI treated with DAIR strategy, and randomized in the experimental group, will receive rifabutin in association with another antibiotic except rifampicin, as-per recommendations for 12 weeks.

Group Type EXPERIMENTAL

Rifabutin

Intervention Type DRUG

2 tablets of 150 mg per day rifabutin tablet daily for 12 weeks in 1 administration with a companion treatment

Interventions

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Rifabutin

2 tablets of 150 mg per day rifabutin tablet daily for 12 weeks in 1 administration with a companion treatment

Intervention Type DRUG

Rifampicin

10 mg/kg per day (range 600 mg to 1,200 mg) rifampicin tablet in 1 daily dose for 12 weeks with a companion treatment

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Hip or knee Prosthetic joint infection treated by debridement, antibiotic therapy initiation and retention of prothesis (DAIR strategy)
2. Infected with at least one of the following microorganisms:

1. Staphylococcus aureus
2. Coagulase-negative staphylococci
3. Microorganisms susceptible to rifampicin and at least one other antibiotic suitable for the treatment of PJI (e.g., penicillin, fluoroquinolone, (doxy/mino)cycline, oxazolidinone, cotrimoxazole, daptomycin, glycopeptide, macrolide, fusidic acid), regardless of sensitivity to methicillin.
4. Age ≥ 18 years
5. At least 2 days of appropriate (i.e., covering pathogen(s) identified in the intraoperative samples) empirical agents are needed. Pre-randomization antimicrobial therapy could be: flucloxacillin, oxacillin, vancomycin, daptomycin. β-lactam plus β-lactamase-inhibitors (e.g. ampicillin+sulbactam, piperacillin+tazobactam), cephalosporins (except ceftazidime), carbapenems, teicoplanin, ceftaroline, ceftobiprole.
6. Signed Inform consent
7. Patient having the rights to French social insurance
8. For women of childbearing potential i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile and excluding oestroprogestative-based contraception, any effective contraceptive: vasectomy (for men), intrauterine device copper, feminine sterilization, condom, sexual abstinence is required. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause

Exclusion Criteria

1. Suspicion of reduce absorption of oral treatment due to abdominal disorder Known or suspected malabsorption (imperfect absorption of food material by the small intestine)
2. Polymicrobial infection due to other than staphylococcus species susceptible to rifampicin
3. Known or suspected allergy to rifabutin and/or rifampicin
4. Diagnosis of endocarditis associated to PJI
5. Renal transplant or Chronic kidney disease with an eGFR of less than 30ml/min/1.73m²
6. Other Solid Organ Transplant
7. Liver cirrhosis, Child-Pugh score C
8. Any other concomitant infection which required a prolonged course of intravenous antibiotic therapy
9. Oestroprogestative-based contraception
10. Oral anticoagulant drugs
11. Other drug-drug interaction that contraindicated rifampicin or rifabutin
12. Porphyria
13. Unable to take oral treatment
14. Receive empirical postoperative antibiotic treatment by rifampicin or rifabutin prior to randomization
15. Pregnancy or lactating women
16. Curator or guardianship or patient placed under judicial protection
17. Participation in other interventional research during the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tourcoing Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eric SENNEVILLE, Md PhD

Role: PRINCIPAL_INVESTIGATOR

CH TOURCOING

Locations

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CHU Amiens Picardie

Amiens, , France

Site Status NOT_YET_RECRUITING

CHU Angers

Angers, , France

Site Status NOT_YET_RECRUITING

CHU Besançon

Besançon, , France

Site Status RECRUITING

CH de Béthune

Béthune, , France

Site Status NOT_YET_RECRUITING

CHU Bordeaux

Bordeaux, , France

Site Status NOT_YET_RECRUITING

APHP Hôpital Ambroise Paré

Boulogne-Billancourt, , France

Site Status NOT_YET_RECRUITING

CHRU Brest

Brest, , France

Site Status RECRUITING

CHU Caen

Caen, , France

Site Status RECRUITING

CH Alpes Leman

Contamine-sur-Arve, , France

Site Status NOT_YET_RECRUITING

CHU Dijon Bourgogne

Dijon, , France

Site Status NOT_YET_RECRUITING

CHU Grenoble Alpes

Grenoble, , France

Site Status NOT_YET_RECRUITING

CHRU Lille

Lille, , France

Site Status RECRUITING

GHICL Hôpital Saint Vincent de Paul

Lille, , France

Site Status NOT_YET_RECRUITING

CHU de Limoges

Limoges, , France

Site Status RECRUITING

GHICL Hôpital Saint Philibert

Lomme, , France

Site Status NOT_YET_RECRUITING

Clinique de la Sauvegarde

Lyon, , France

Site Status NOT_YET_RECRUITING

Hospices Civils de Lyon

Lyon, , France

Site Status NOT_YET_RECRUITING

APHM Hôpital Nord

Marseille, , France

Site Status NOT_YET_RECRUITING

CHU Nice

Nice, , France

Site Status NOT_YET_RECRUITING

CH Annecy Genevois

Pringy, , France

Site Status RECRUITING

CH Cornouaille

Quimper, , France

Site Status NOT_YET_RECRUITING

CHU Reims

Reims, , France

Site Status NOT_YET_RECRUITING

CHU de Rennes

Rennes, , France

Site Status RECRUITING

CHU Saint Etienne

Saint-Priest-en-Jarez, , France

Site Status NOT_YET_RECRUITING

CHRU Strasbourg

Strasbourg, , France

Site Status NOT_YET_RECRUITING

Hôpital d'instruction des armées Sainte Anne

Toulon, , France

Site Status RECRUITING

Clinique Joseph Ducuing

Toulouse, , France

Site Status NOT_YET_RECRUITING

Clinique Médipole Garonne

Toulouse, , France

Site Status NOT_YET_RECRUITING

CH Tourcoing

Tourcoing, , France

Site Status RECRUITING

CHRU Tours

Tours, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Eric SENNEVILLE, MD PhD

Role: CONTACT

0320694949

Solange TREHOUX

Role: CONTACT

0320694280

Facility Contacts

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Benoit BRUNSCHWEILER

Role: primary

Kévin BOUILLER

Role: primary

Fréderic-Antoine DAUCHY

Role: primary

Aurélien DINH

Role: primary

Severine ANSART

Role: primary

Lionel PIROTH

Role: primary

Henry MIGAUD

Role: primary

Anne-Laure BLANC

Role: primary

Tristan FERRY

Role: primary

Johan COURJON

Role: primary

Violaine TOLSMA

Role: primary

Lydie KHATCHATOURIAN

Role: primary

Cédric ARVIEUX

Role: primary

Cécile RONDE-OUSTAU

Role: primary

Eric SENNEVILLE

Role: primary

Louis BERNARD

Role: primary

Other Identifiers

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RIPH_2019_01

Identifier Type: -

Identifier Source: org_study_id

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