Comprehensive Ambulatory Antibiotics for the Treatment of Congenital Syphilis

NCT ID: NCT06921213

Last Updated: 2025-05-04

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

PHASE2

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2027-06-30

Brief Summary

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CARES-1 is a randomised, open-label, phase II pharmacokinetic (PK) and safety study of ambulatory antibiotics for the treatment of neonates with "all-risk" asymptomatic congenital syphilis.

Detailed Description

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Conditions

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Syphilis, Congenital

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
It is not possible to blind the intervention to either participants or care providers given variation in route of administration and duration of therapy. Individuals assessing clinical and laboratory outcomes will be blinded to study group.

Study Groups

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Oral Linezolid

10 day course of Linezolid twice a day

Group Type EXPERIMENTAL

Linezolid (LZD)

Intervention Type DRUG

Ten day course. Oral Linezolid dosed at 10mg/kg twice a day.

Oral Amoxicillin

10 day course of Amoxicillin twice a day

Group Type EXPERIMENTAL

Amoxicillin

Intervention Type DRUG

Ten day course. Oral Linezolid dosed at 50mg/kg twice a day.

IM Benzathine penicillin

Single IM dose of IM Benzathine penicillin

Group Type ACTIVE_COMPARATOR

Benzathine Penicillin G

Intervention Type DRUG

Single IM dose 50,000iu/kg

Interventions

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Linezolid (LZD)

Ten day course. Oral Linezolid dosed at 10mg/kg twice a day.

Intervention Type DRUG

Amoxicillin

Ten day course. Oral Linezolid dosed at 50mg/kg twice a day.

Intervention Type DRUG

Benzathine Penicillin G

Single IM dose 50,000iu/kg

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Infants at risk of congenital syphilis at birth defined as:

1. an infant born to a mother who tests positive for syphilis in pregnancy using registered and licensed locally-available diagnostic tests for example but not limited to a Treponemal rapid POCT, an RPR or both.

AND
2. the mother is untreated in the current pregnancy defined as:

i. she tested positive at antenatal care and received no treatment OR ii. she was never tested during antenatal care OR iii. she tested negative at antenatal care and positive on re-testing at delivery

OR c. the mother is inadequately treated in the current pregnancy defined as:

i. Having received a non-penicillin based treatment regimen; and/or ii. Does not have documentation of 3 doses of IM Benzathine Penicillin, given 7-10 days apart, with the last dose given \> 30 days prior to delivery OR b. The mother was adequately treated in the current pregnancy BUT considers herself at risk of re-infection following a midwife delivered explanation of risk (partner treatment, multiple partners etc).
2. Infants who are asymptomatic for a diagnosis of congenital syphilis following application of a clinical proforma by the study team (Appendix 1)
3. Infants who are less than \<= 7 days of life AND with a post-menstrual age (PMA) of 34-42 weeks (Appendix 2).
4. Infants who are tolerating enteral feeds, including if they are being administered by an NG tube.

Exclusion Criteria

\- 1. The infant's clinical condition at birth or prior to randomisation requires ongoing (\> 48 hours) treatment with antibiotics with the potential for anti-treponemal activity i.e. B-lactams, Cephalosporins, Carbapenems.

2\. They have a birthweight \<2kg 3. They are nil by mouth. 4. They have a life-limiting congenital anomaly
Minimum Eligible Age

0 Days

Maximum Eligible Age

7 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University College Dublin

OTHER

Sponsor Role collaborator

University of Stellenbosch

OTHER

Sponsor Role collaborator

Malawi Liverpool Wellcome Programme

OTHER

Sponsor Role collaborator

University of Sydney

OTHER

Sponsor Role collaborator

Murdoch Childrens Research Institute

OTHER

Sponsor Role collaborator

MRC CTU at UCL

UNKNOWN

Sponsor Role collaborator

PHPT/AMS Laboratory, Faculty of Associated Medical Sciences, Chiang Mai University

UNKNOWN

Sponsor Role collaborator

London School of Hygiene and Tropical Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Marks

Role: PRINCIPAL_INVESTIGATOR

London School of Hygiene and Tropical Medicine

Bridget Freyne

Role: PRINCIPAL_INVESTIGATOR

University College Dublin

Locations

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Universitas Indonesia

Jakarta, , Indonesia

Site Status

Malawi Liverpool Wellcome Programme

Blantyre, , Malawi

Site Status

Stellenbosch

Stellenbosch, , South Africa

Site Status

Countries

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Indonesia Malawi South Africa

Central Contacts

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Sarah Prentice

Role: CONTACT

+4420 7636 8636

Facility Contacts

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Phoebe Williams

Role: primary

Mary Mc Cauley

Role: primary

+265 111 81 19 18

Lisa Frigati

Role: primary

+27 21 808 9111

Other Identifiers

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31732

Identifier Type: -

Identifier Source: org_study_id

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