Ampicillin and Ceftriaxone for the Treatment of Enterococcus Faecalis Infective Endocarditis.

NCT ID: NCT06423898

Last Updated: 2025-07-25

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

PHASE4

Total Enrollment

284 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-09

Study Completion Date

2028-12-31

Brief Summary

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Phase IV, open-label, randomized and multicenter clinical trial to prove that patients with Enterococcus faecalis infective endocarditis treated with an antibiotic treatment as a continuous infusion is non-inferior to the standard treatment, usually administered in hospitalized patients.

Detailed Description

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The aim of the study is to prove that the continuous infusion of antibiotic treatment for the patients with Enterococcus faecalis infective endocarditis is as effective and safe as the standard treatment. The continuous infusion modality of treatment is expected to provide numerous benefits for individual patients, global health, and for the National Health Care System by reducing to hospital stays from 4-6 weeks to approximately 2-3 weeks and hospital-driven complications.

The mortality, rate of serious adverse events, total number of days of antibiotic treatment and days of hospitalization, among others, are included as secondary objectives.

This is a pragmatic study as the number or visits performed for the study are similar to the normal clinical follow-up for this patients. Final contact and final visit for the study will be performed at 365 days after the 42 days of treatment.

Conditions

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Endocarditis, Infective

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment Randomized 1:1 to experimental group (continuous infusion arm) or control group (intermittent infusion arm)
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Continuous intravenous antibiotic infusion

Ampicillin 12g/24h plus ceftriaxone 4g/12h continuous infusion. The duration of treatment will be 42 days.

Group Type EXPERIMENTAL

Ampicillin plus ceftriaxone in continuous infusion

Intervention Type DRUG

Continuous intravenous antibiotic infusion during 42 days for Infective Endocarditis

Standard treatment

Ampicillin 2g/4h plus ceftriaxone 2g/12h intermittent infusion for a minimum of 14 days. Starting on day 14 of treatment, if the patient is discharged from the hospital, the following treatments will be permitted:

1. Intravenous treatment in TADE programs according to the following regimens:

1. Ampicillin 2g/4h plus ceftriaxone 2g/12h as an intermittent infusion
2. Teicoplanin 10-12mg/kg/24h
3. Daptomycin 10-12mg/kg/24h
4. Dalbavancin: Initial dose: 2 doses of 1500mg every 2 weeks. Maintenance dose: 1500mg every 15days.
5. Linezolid: 600mg/12hours
2. Oral treatment according to the following regimens:

1. Amoxicillin 1 g/6h + Moxifloxacin 400mg/24h.
2. Amoxicillin 1 g/6h + Linezolid 600 mg/12h.
3. Amoxicillin 1 g/6h + Rifampin 600 mg/12h.
4. Linezolid 600 mg/12h + Moxifloxacin 400mg/24h.
5. Linezolid 600 mg/12h + Rifampin 600 mg/12h. The duration of treatment will be 42 days

Group Type ACTIVE_COMPARATOR

Ampicillin plus ceftriaxone in intermittent infusion of 14 days, after which the treatment may be changed

Intervention Type DRUG

Ampicillin plus ceftriaxone as an intermittent infusion for a minimum of 14 days. After, if the patient is discharged from the hospital, the following treatments, until the 42-day treatment period is completed:

1. Intravenous treatment according to the following regimens:

Ampicillin plus ceftriaxone as an intermittent infusion, teicoplanin, daptomycin, dalbavancin or linezolid.
2. Oral treatment according to the following regimens: amoxicillin plus moxifloxacin, amoxicillin plus linezolid, amoxicillin plus rifampin, linezolid plus moxifloxacin or linezolid plus rifampin.

Interventions

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Ampicillin plus ceftriaxone in continuous infusion

Continuous intravenous antibiotic infusion during 42 days for Infective Endocarditis

Intervention Type DRUG

Ampicillin plus ceftriaxone in intermittent infusion of 14 days, after which the treatment may be changed

Ampicillin plus ceftriaxone as an intermittent infusion for a minimum of 14 days. After, if the patient is discharged from the hospital, the following treatments, until the 42-day treatment period is completed:

1. Intravenous treatment according to the following regimens:

Ampicillin plus ceftriaxone as an intermittent infusion, teicoplanin, daptomycin, dalbavancin or linezolid.
2. Oral treatment according to the following regimens: amoxicillin plus moxifloxacin, amoxicillin plus linezolid, amoxicillin plus rifampin, linezolid plus moxifloxacin or linezolid plus rifampin.

Intervention Type DRUG

Other Intervention Names

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Experimental regimen Control regimen

Eligibility Criteria

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Inclusion Criteria

* Adult patients
* Possible or definitive diagnosis of infective endocarditis due to Enterococcus faecalis
* Signed informed consent of patients

Exclusion Criteria

* Allergy to penicillins or cephalosporins
* Pregnancy and lactation
* Polymicrobial infection including microorganisms different to E. faecalis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Spanish Clinical Research Network - SCReN

NETWORK

Sponsor Role collaborator

Fundación Pública Andaluza para la gestión de la Investigación en Sevilla

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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HUVR Cesar Arístides de Alarcón González, MD-PhD

Role: PRINCIPAL_INVESTIGATOR

Fundación para la Gestión de la Investigación en Salud de Sevilla

Locations

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Hospital Universitario de Álava

Alava, , Spain

Site Status RECRUITING

Hospital Universitario de Cruces

Barakaldo, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Vall d'Hebron

Barcelona, , Spain

Site Status NOT_YET_RECRUITING

Hospital Clínico de Barcelona

Barcelona, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitario de Donostia

Donostia / San Sebastian, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Virgen de las Nieves

Granada, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital San Pedro

Logroño, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Gregorio Marañón

Madrid, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Clínico San Carlos

Madrid, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitario La Paz

Madrid, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitario Puerta del Hierro

Madrid, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Regional de Málaga

Málaga, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Virgen de la Victoria

Málaga, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario de Canarias

San Cristóbal de La Laguna, , Spain

Site Status RECRUITING

Hospital Universitario Marqués de Valdecilla

Santander, , Spain

Site Status RECRUITING

Hospital Universitario Virgen Macarena

Seville, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Virgen del Rocío

Seville, , Spain

Site Status RECRUITING

Hospital Universitari MútuaTerrassa

Terrassa, , Spain

Site Status ACTIVE_NOT_RECRUITING

Countries

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Spain

Central Contacts

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Laura Herrera Hidalgo, MD-PhD

Role: CONTACT

+34955013414

Clara M Rosso Fernández, MD-PhD

Role: CONTACT

+34955013414

Facility Contacts

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Juan Carlos Gainzarain, MD

Role: primary

Nuria Fernández Hidalgo, MD

Role: primary

Guillermo Cuervo Requena, MD

Role: primary

Ana Muñoz Gómez, MD

Role: primary

Belén Loeches, MD

Role: primary

Remedios Alemán, MD

Role: primary

Mª Carmen Fariñas, MD

Role: primary

MD

Role: backup

Cesar Aristides de Alarcon gonzalez, MD

Role: primary

+34 955 013414

Other Identifiers

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DOBLEI

Identifier Type: -

Identifier Source: org_study_id

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