Efficacy and Safety of Sinquanon for Prevention of Antibiotic-associated Diarrhea in Adults

NCT ID: NCT05607056

Last Updated: 2024-10-21

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

COMPLETED

Clinical Phase

NA

Total Enrollment

565 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-27

Study Completion Date

2023-04-25

Brief Summary

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The purpose of this study is to evaluate the efficacy of a probiotic, SINQUANON, on the reduction of the occurrence of diarrhea associated with antibiotic use in adults.

Detailed Description

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The study aims to evaluate the efficacy of a specialized multi-strain probiotic, SINQUANON, on the reduction of the incidence of antibiotic-associated diarrhea in adults and to demonstrate the benefit of administering the specialized multi-strain probiotic as a routine add-on to antibiotic therapy on prevention of antibiotic-associated diarrhea in adults who take antibiotics in the outpatient setting.

Conditions

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Antibiotic-associated Diarrhea

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, multicenter, double-blind, placebo-controlled, randomized, parallel-arm clinical study
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators
Investigators will be provided with coded and identical products. Each individual involved in the study will be blinded to the assignment until study completion. Considering the established safety profile of the probiotic strains no necessity is foreseen for urgent unblinding of treatment assignment. With this in mind, no copies of the treatment assignments will be stored at the enrollment sites. If needed, the Investigators may receive information about the assignment of a particular subject only after review and approval by the Medical monitor. No information about the subjects will be shared with the company conducting the randomization.

Study Groups

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Probiotic

During the antibiotic dosing (from 5 to 10 days): 2 capsules once a day 2 hours before or 2 hours after antibiotic administration. 14 days following completion of antibiotic dosing: 1 capsule a day.

Group Type EXPERIMENTAL

Sinquanon

Intervention Type DIETARY_SUPPLEMENT

This probiotic food supplement includes fourteen probiotic bacterial strains of Lactobacillus Spp, Bifidobacterium Spp., Bacillus coagulans, Saccharomyces boulardii, three prebiotics and Vitamin-B complex - B1, B2, B3, B6, B7, B9 in an enterosolvent cellulose capsule. The product includes supplementary substances: maltodextrin and magnesium stearate.

2 capsules once a day during the antibiotic dosing. 1 capsule a day for 14 days following completion of antibiotic dosing.

Placebo

During the antibiotic dosing (from 5 to 10 days): 2 capsules once a day 2 hours before or 2 hours after antibiotic administration. 14 days following completion of antibiotic dosing: 1 capsule a day.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

The placebo product will have the same appearance as the active product and the same composition but without the live bacteria, prebiotics, and vitamin-B complex. 2 capsules once a day during the antibiotic dosing. 1 capsule a day for 14 days following completion of antibiotic dosing.

Interventions

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Sinquanon

This probiotic food supplement includes fourteen probiotic bacterial strains of Lactobacillus Spp, Bifidobacterium Spp., Bacillus coagulans, Saccharomyces boulardii, three prebiotics and Vitamin-B complex - B1, B2, B3, B6, B7, B9 in an enterosolvent cellulose capsule. The product includes supplementary substances: maltodextrin and magnesium stearate.

2 capsules once a day during the antibiotic dosing. 1 capsule a day for 14 days following completion of antibiotic dosing.

Intervention Type DIETARY_SUPPLEMENT

Placebo

The placebo product will have the same appearance as the active product and the same composition but without the live bacteria, prebiotics, and vitamin-B complex. 2 capsules once a day during the antibiotic dosing. 1 capsule a day for 14 days following completion of antibiotic dosing.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Male or female subject aged 18 to 60 years.
* The subject has given written informed consent after being provided orally with information about the study objective and design, including the administration regimen of the studied probiotic and the study procedures, the available safety data, as well as the rights and obligations of a participant.
* The subject initiates oral antibiotic treatment in the ambulatory setting.
* Acceptable antibiotic therapy:

* Broad-spectrum penicillins
* Cephalosporins
* Quinolones
* Tetracyclines

Sequential administration of two antibiotics from the allowed groups is permitted, if the total duration of the antibiotic treatment does not exceed 10 days.

* Planned duration of the antibiotic treatment of 5 to 10 days.
* Body mass index (BMI) of 18.0 to 29.9 kg/m2
* In the opinion of the Investigator, the subject can adhere to the visit schedule, to be compliant with the trial treatment regimen and to complete the study.
* The patient has a smartphone and can use it.

Exclusion Criteria

* Antibiotics use within 60 days prior to randomization.
* Daily consumption of probiotics, yogurt with probiotics and inability to stop this consumption.
* Use of antidiarrheal medications, laxatives, enemas, or suppositories within 1 week prior to randomization and for the duration of the trial.
* An episode of diarrhea within 30 days before screening, defined as ≥3 loose or liquid stools over 24 hours, regardless of the cause of the diarrhea.
* Acute or chronic constipation - average number of formed stools \<3 per week.
* Allergy or hypersensitivity to any of the ingredients of the trial product.
* Allergy or hypersensitivity to the antibiotic prescribed on Day 1.
* Prior documented infection with Clostridioides difficile ≤3 months before screening.
* History of chronic gastrointestinal conditions, including irritable bowel syndrome, chronic constipation, chronic diarrhea, dyspepsia, gastroesophageal reflux disease, diverticulitis, ulcerative colitis, Crohn's disease or any other abnormality in the absorption or gastrointestinal dysfunction.
* Use of proton-pump inhibitors (PPIs) within 30 days prior to Day 1 and for the duration of the study.
* Surgery to the intestines, artificial heart valve, history of rheumatological heart disease or infectious endocarditis within one year prior to screening.
* Immunosuppressive therapy or any condition causing immunosuppression (including hematologic malignancies, AIDS, long-lasting corticosteroid treatment).
* Planned administration of antibiotics, different from those acceptable for the study.
* Patients in severe condition requiring urgent hospitalization or planned hospitalization during the study.
* Planned administration of antibiotics \>10 days.
* BMI ≥ 30 kg/m2.
* Pregnant or lactating women; women who plan to get pregnant during the study.
* Drug abuse or alcohol within the past year.
* Unstable medical conditions, in the judgement of the Investigator.
* Eating disorders (for example, anorexia, bulimia).
* On a vegan diet.
* Participation in a clinical trial within 60 days prior to randomization.
* Inability to comply with the study protocol.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Neopharm Bulgaria Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Georgi Momekov, Prof PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Pharmacology, Pharmacotherapy and Toxicology, Medical University of Sofia

Karen Dzhambazov, Prof, PhD

Role: PRINCIPAL_INVESTIGATOR

University hospital for active treatment Sveti Georgi, Medical University-Plovdiv

Nikolay Sapundziev, Prof, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Neurosurgery and Otorhinolaryngology, Medical University - Varna

Milena Encheva, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Military Medical Academy, Bulgaria

Boris Bogov, Prof, PhD

Role: PRINCIPAL_INVESTIGATOR

UMHAT "Sveta Anna"

Rosen Nikolov, Prof, MD

Role: PRINCIPAL_INVESTIGATOR

UMHAT St Ivan Rilski

Rumen Benchev, Prof

Role: PRINCIPAL_INVESTIGATOR

Hill Clinic

Vladimir Hodzhev, Prof, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital "St George"

Spiridon Todorov, Prof, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital "Tsaritsa Yoanna - ISUL"

Vania Youroukova, Prof, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital for Pulmonary Diseases " St. Sofia"

Locations

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University Hospital "St George"

Plovdiv, , Bulgaria

Site Status

University Hospital for Pulmonary Diseases " St. Sofia"

Sofia, , Bulgaria

Site Status

University Hospital "Tsaritsa Yoanna - ISUL"

Sofia, , Bulgaria

Site Status

Countries

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Bulgaria

References

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Konstantinidis T, Tsigalou C, Karvelas A, Stavropoulou E, Voidarou C, Bezirtzoglou E. Effects of Antibiotics upon the Gut Microbiome: A Review of the Literature. Biomedicines. 2020 Nov 16;8(11):502. doi: 10.3390/biomedicines8110502.

Reference Type BACKGROUND
PMID: 33207631 (View on PubMed)

Francino MP. Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances. Front Microbiol. 2016 Jan 12;6:1543. doi: 10.3389/fmicb.2015.01543. eCollection 2015.

Reference Type BACKGROUND
PMID: 26793178 (View on PubMed)

Mekonnen SA, Merenstein D, Fraser CM, Marco ML. Molecular mechanisms of probiotic prevention of antibiotic-associated diarrhea. Curr Opin Biotechnol. 2020 Feb;61:226-234. doi: 10.1016/j.copbio.2020.01.005. Epub 2020 Feb 19.

Reference Type BACKGROUND
PMID: 32087535 (View on PubMed)

Barbut F, Meynard JL. Managing antibiotic associated diarrhoea. BMJ. 2002 Jun 8;324(7350):1345-6. doi: 10.1136/bmj.324.7350.1345. No abstract available.

Reference Type BACKGROUND
PMID: 12052785 (View on PubMed)

Szajewska H, Kolodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther. 2015 Nov;42(10):1149-57. doi: 10.1111/apt.13404. Epub 2015 Sep 13.

Reference Type BACKGROUND
PMID: 26365389 (View on PubMed)

Szajewska H, Kolodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015 Oct;42(7):793-801. doi: 10.1111/apt.13344. Epub 2015 Jul 27.

Reference Type BACKGROUND
PMID: 26216624 (View on PubMed)

Ouwehand AC. A review of dose-responses of probiotics in human studies. Benef Microbes. 2017 Apr 26;8(2):143-151. doi: 10.3920/BM2016.0140. Epub 2016 Dec 23.

Reference Type BACKGROUND
PMID: 28008787 (View on PubMed)

Szajewska H, Canani RB, Guarino A, Hojsak I, Indrio F, Kolacek S, Orel R, Shamir R, Vandenplas Y, van Goudoever JB, Weizman Z; ESPGHAN Working Group for ProbioticsPrebiotics. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. J Pediatr Gastroenterol Nutr. 2016 Mar;62(3):495-506. doi: 10.1097/MPG.0000000000001081.

Reference Type BACKGROUND
PMID: 26756877 (View on PubMed)

Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827. doi: 10.1002/14651858.CD004827.pub4.

Reference Type BACKGROUND
PMID: 26695080 (View on PubMed)

Gao XW, Mubasher M, Fang CY, Reifer C, Miller LE. Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea prophylaxis in adult patients. Am J Gastroenterol. 2010 Jul;105(7):1636-41. doi: 10.1038/ajg.2010.11. Epub 2010 Feb 9.

Reference Type BACKGROUND
PMID: 20145608 (View on PubMed)

Hodzhev V, Dzhambazov K, Sapundziev N, Encheva M, Todorov S, Youroukova V, Benchev R, Nikolov R, Bogov B, Momekov G, Hadjiev V. High-dose Probiotic Mix of Lactobacillus spp., Bifidobacterium spp., Bacillus coagulans, and Saccharomyces boulardii to Prevent Antibiotic-associated Diarrhea in Adults: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial (SPAADA). Open Forum Infect Dis. 2024 Oct 21;11(11):ofae615. doi: 10.1093/ofid/ofae615. eCollection 2024 Nov.

Reference Type DERIVED
PMID: 39529939 (View on PubMed)

Other Identifiers

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2022-002817-40

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

SPAADA202211_001

Identifier Type: -

Identifier Source: org_study_id

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