Does Additional Use of Preoperative Azithromycin Decrease Posthysterectomy Infections

NCT ID: NCT05337566

Last Updated: 2024-08-21

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

NA

Total Enrollment

2278 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-05

Study Completion Date

2030-12-31

Brief Summary

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During hysterectomy bacteria may enter into the peritoneal cavity through vaginal opening and contaminate the healing tissues. The risk for deep infection after hysterectomy is about 5%. By reducing post-hysterectomy infections, it is possible to reduce individual burden of disease in addition to the direct and indirect financial costs. This study primary aim is to assess if prophylactic preoperative use of azithromycin in addition to generally used cefuroxime decreases post-hysterectomy infections as compared to cefuroxime only prophylaxis during 30 days after hysterectomy. Secondary aim is to assess if there is change in post-hysterectomy superficial infections, urinary tract infections, or post-operative fever between the cohorts and to report possible side-effects of the used antibiotics. In addition, the study finds out a possible role of bacterial vaginosis and microbiome n post-hysterectomy infections.

Detailed Description

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Conditions

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Infection Post Op Hysterectomy Antibiotics Prophylactic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors
single blinded - the placebo tablets slightly differ from the azithromycin tablets, therefore they are sealed in package which is given straight to the participant

Study Groups

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Azithromycin + Cefuroxime

Changed with renewed study permissions:

These patients will receive Azithromycin 500 mg (2 tablets) per orally on the operation day when they arrive to the hospital and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose bosy mass index is 30 or more) in the operating theatre before the incision.

The previous description:

These patients will receive Azithromycin 500 mg (2 tablets) per orally in the evening before the operation and single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose body mass index is 30 or more) in the operating theatre before the incision.

Group Type EXPERIMENTAL

Azithromycin Pill + Cefuroxime

Intervention Type DRUG

Azithromycin 500 mg (2 tablets) per orally when arriving to the hospital before the operation and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose body mass index is 30 or more) in the operating theatre before the incision

Placebo + Cefuroxime

Changed with new study permissions:

These patients will receive placebo (2 tablets) per orally on the operation day when they arrive to the hospital and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose bosy mass index is 30 or more)in the operating theatre before the incision.

The previous description:

These patients will receive placebo (2 tablets) per orally in the evening before the operation and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose body mass index is 30 or more) in the operating theatre before the incision.

Group Type ACTIVE_COMPARATOR

Placebo + Cefuroxime

Intervention Type DRUG

Placebo (2 tablets) per orally in the evening when arriving to the hospital before the operation and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose body mass index is 30 or more) in the operating theatre before the incision

Interventions

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Azithromycin Pill + Cefuroxime

Azithromycin 500 mg (2 tablets) per orally when arriving to the hospital before the operation and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose body mass index is 30 or more) in the operating theatre before the incision

Intervention Type DRUG

Placebo + Cefuroxime

Placebo (2 tablets) per orally in the evening when arriving to the hospital before the operation and a single dose Cefuroxime 1.5g (when body mass index is under 30) or 3g (for those whose body mass index is 30 or more) in the operating theatre before the incision

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Women undergoing hysterectomy for benign indication in University Hospitals (Helsinki University Hospital, Turku University Hospital, Tampere University Hospital, Oulu University Hospital and Kuopio University Hospital) who have not any contraindications for azithromycin or cefuroxime.

Exclusion Criteria

* Inability to understand the study protocol.
* Allergy for either cefuroxime or azithromycin.
* Congenital or acquired prolonged Q-T-corrected interval. All the participants will be asked about arrhythmias and whether they have congenital arrhythmias in the family,
* Electrocardiogram will be checked for all the participants.
* Use of medicines that may prolong Q-T-corrected interval (class Ia arrhythmia medications, quinidine, procainamide, and class III arrhythmia medications dofetilide, amiodarone and sotalol).
* Use of selective serotonin reuptake inhibitor medication and prolonged Q-T-corrected interval.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Turku

OTHER

Sponsor Role collaborator

Tampere University Hospital

OTHER

Sponsor Role collaborator

Kuopio University Hospital

OTHER

Sponsor Role collaborator

Oulu University Hospital

OTHER

Sponsor Role collaborator

Jyväskylä Central Hospital

OTHER

Sponsor Role collaborator

Helsinki University Central Hospital

OTHER

Sponsor Role lead

Responsible Party

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Päivi Rahkola-Soisalo

Adjuct professor, M.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Päivi Rahkola-Soisalo, Adj prof, MD

Role: PRINCIPAL_INVESTIGATOR

Helsinki University Central Hospital

Tomi Mikkola, Prof, MD

Role: STUDY_CHAIR

Helsinki University Central Hospital

Päivi Rahkola-Soisalo, Adj prof, MD

Role: STUDY_DIRECTOR

Helsinki University Central Hospital

Locations

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Helsinki University Central Hospital

Helsinki, , Finland

Site Status RECRUITING

Jyväskylä Central Hospital

Jyväskylä, , Finland

Site Status RECRUITING

Kuopio University Central Hospital

Kuopio, , Finland

Site Status RECRUITING

Oulu University Central Hospital

Oulu, , Finland

Site Status RECRUITING

Tampere University Central Hospital

Tampere, , Finland

Site Status RECRUITING

Turku University Central Hospital

Turku, , Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Päivi K Rahkola-Soisalo, Adj prof,MD

Role: CONTACT

+358504270411

Ninja Savonius, MD

Role: CONTACT

+358503466986

Facility Contacts

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Päivi K Rahkola-Soisalo, Adj prof,MD

Role: primary

+358 50 4270411

Ninja Savonius, MD

Role: backup

+358503466986

Jaana Seikkula, PhD

Role: primary

+358 41 548 3562

Henna Kärkkäinen, PhD

Role: primary

+358 44 7172741

Sari Koivurova, PhD

Role: primary

+358 8 3150211

Riikka Niemi, PhD

Role: primary

+358 3 31169083

Pia Heinonen, PhD

Role: primary

+358 2 313 5002

Other Identifiers

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2021-003467-10

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

HUS/117/2022

Identifier Type: -

Identifier Source: org_study_id

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