Impact of Rifampicin in Treatment Outcome of Cutibacterium Acnes Prosthetic Joint Infections

NCT ID: NCT05902221

Last Updated: 2024-03-13

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

NOT_YET_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

235 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-30

Study Completion Date

2027-07-01

Brief Summary

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Cutibacterium acnes is involved in nearly 40% of shoulder prosthetic joint infections (PJI). After shoulder prothesis, C. acnes mainly affects hip prosthesis. One recent work from the Lyon (France) bone and joint infections reference center with data focusing mainly on hip and knee PJI has reported that C. acnes is the leading cause of late-onset PJI after coagulase negative staphylococci (CNS) (late acute PJI not considered).

In such late-onset device-related infection, biofilm, as produced by C. acnes during PJI represents a major hurdle on the path to patient's cure. Because biofilm-associated bacteria have a slower metabolism and a lower multiplication rate than planktonic bacteria, antibiotic susceptibility can be hampered.

Rifampicin is an antibiotic with low minimal bactericidal concentration against S. aureus and CNS biofilm-associated bacteria8 which significantly influence patient's outcome during staphylococci PJI.

Detailed Description

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Conditions

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Infections Joint Prosthetic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Multicenter, randomized two-arm (parallel) comparative open-label cohort clinical trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Antibiotic treatment backbone alone

Amoxicillin or moxifloxacin to the investigator's discretion

Group Type ACTIVE_COMPARATOR

amoxicillin or moxifloxacin

Intervention Type DRUG

Antibiotic treatment back bone during 12 weeks

Antibiotic treatment backbone + rifampicin

Amoxicillin or moxifloxacin to the investigator's discretion + RIMACTAN

Group Type EXPERIMENTAL

amoxicillin or moxifloxacin + rifampicin

Intervention Type DRUG

Antibiotic treatment back bone during 12 weeks + rifampicin

Interventions

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amoxicillin or moxifloxacin

Antibiotic treatment back bone during 12 weeks

Intervention Type DRUG

amoxicillin or moxifloxacin + rifampicin

Antibiotic treatment back bone during 12 weeks + rifampicin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age: \> or =18 years old;
* Monomicrobial, rifampicin susceptible Cutibacterium acnes late total knee arthroplasty (TKA) or hip arthroplasty (total, THA or hemiarthroplasty, HH) or shoulder arthroplasty (total, TSA or hemiarthroplasty, SH) infection treated surgically with single-stage or two-stage revision;
* Isolation of C. acnes on two distinct per-operative samples collected during the single-stage or the two-stage revision
* Based on the antimicrobial susceptibility test of the C. acnes and the medical history of the patient, the PJI can be treated with amoxicillin or moxifloxacin;
* Women considered of childbearing potential (WOCBP) requires use of a highly effective contraceptive measure as intrauterine device (IUD), intrauterine hormone-releasing system (IUS), documented bilateral tubal occlusion, documented vasectomised partner, sexual abstinence. Contraception should be maintained during treatment and until the end of relevant systemic exposure.

Exclusion Criteria

* Contraindication to Rifampicin (included ongoing treatment contraindicated with rifampicin)
* Contraindication to Amoxicillin AND moxifloxacin (included ongoing treatment contraindicated with these medicines)
* Empirical antibiotic treatment not administered during the 24 hours following revision surgery;
* Inactive empirical antibiotic treatment following surgery according to the AST of the bacteria;
* disease-modifying treatment incompatible with the inducer effect of rifampicin
* Liver cirrhosis;
* Pregnancy: a pregnancy blood test will be performed on all women of childbearing age. The results will be sent to the patient by the doctor of their choice;
* Porphyria;
* Renal insufficiency with GFR \< 30ml/min/1.73 m2 (CKD-EPI);
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Universitaire de Nice

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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CH Annecy Genevois

Annecy, , France

Site Status

CHU de BORDEAUX

Bordeaux, , France

Site Status

HCL

Lyon, , France

Site Status

AP-HM

Marseille, , France

Site Status

CHU de MONTPELLIER

Montpellier, , France

Site Status

CHU de Nantes

Nantes, , France

Site Status

CHU de NICE

Nice, , France

Site Status

Dianonesses croix saint simon

Paris, , France

Site Status

CHU de Rennes

Rennes, , France

Site Status

CHU Toulouse

Toulouse, , France

Site Status

Ch Tourcoing

Tourcoing, , France

Site Status

CHRU Tours

Tours, , France

Site Status

Countries

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France

Central Contacts

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Johan COURJON, MD

Role: CONTACT

+33(0)492034562

Facility Contacts

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Gabriel MACHEDA

Role: primary

Tristan FERRY

Role: primary

Florent VALOUR

Role: backup

Carole ELDIN

Role: primary

Raphaël LECOMTE

Role: primary

Johan COURJON

Role: primary

+33492034562

Irit TOUITOU

Role: backup

+3349203847

Valérie ZELLER

Role: primary

Cédric ARVIEUX

Role: primary

Philippe DELOBEL

Role: primary

Marion LACASSE

Role: primary

Other Identifiers

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21-APN-02

Identifier Type: -

Identifier Source: org_study_id

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