Precision Dosing of Beta-lactam Antibiotics in Critically Ill Children

NCT ID: NCT06929702

Last Updated: 2025-04-16

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

PHASE4

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-22

Study Completion Date

2027-10-01

Brief Summary

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The overall objective of this study is to investigate the impact of early model-informed precision dosing (MIPD) on target attainment of three beta-lactam antibiotics (amoxicillin-clavulanic acid, piperacillin-tazobactam and meropenem) in critically ill children. This evaluation includes a comparison with the more standard approach on clinical and patient-oriented measures.

Detailed Description

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Conditions

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Amoxicillin-clavulanate Piperacillin-tazobactam Meropenem

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Participants and legal representatives are blinded for the allocation to the intervention or standard-of-care arm until the end of study. The statistician is kept blinded until after data analysis.

Study Groups

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Standard of Care beta-lactam treatment

Beta-lactam standard-of-care dosing regimen, as currently used at participating wards, during 28 day study period

Group Type ACTIVE_COMPARATOR

Beta-lactam antibiotic

Intervention Type DRUG

amoxicillin-clavulanic acid, piperacillin-tazobactam, meropenem treatment

Beta-lactam model-informed precision dosing

fT\>MIC-based model-informed precision dosing of beta-lactam antibiotics using a dosing calculator during 28 day study period.

Group Type EXPERIMENTAL

Beta-lactam antibiotic

Intervention Type DRUG

amoxicillin-clavulanic acid, piperacillin-tazobactam, meropenem treatment

Beta-lactam model-informed precision dosing

Intervention Type DEVICE

A dosing calculator is used for the prediction of starting doses (a priori dose predictions) and follow-up doses (a posteriori calculations), using a target 100% fT\>MIC.

Interventions

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Beta-lactam antibiotic

amoxicillin-clavulanic acid, piperacillin-tazobactam, meropenem treatment

Intervention Type DRUG

Beta-lactam model-informed precision dosing

A dosing calculator is used for the prediction of starting doses (a priori dose predictions) and follow-up doses (a posteriori calculations), using a target 100% fT\>MIC.

Intervention Type DEVICE

Other Intervention Names

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amoxicillin-clavulanic acid piperacillin-tazobactam meropenem Dosing calculator

Eligibility Criteria

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Inclusion Criteria

* Subject aged between 0 - 17 years 10 months.
* Subject admitted to a participating ward unit (Neonatal Intensive Care Unit, Pediatric Intensive Care Unit, Pediatric Hematology-Oncology unit).
* Strongly suspected or confirmed systemic infection.
* Subject planned to start on intravenous amoxicillin-clavulanic acid, piperacillin-tazobactam or meropenem treatment at least aimed for a minimum duration of two days at time of inclusion. If the subject was previously treated with the same beta-lactam, the minimum interval to the previous beta-lactam treatment episode is
* 40 hours for amoxicillin-clavulanic acid (based on elimination half-life)
* 8 hours for piperacillin-tazobactam and meropenem (based on elimination half-life) Subject planned to start on intravenous amoxicillin (without clavulanic acid) will not be included.
* Informed consent/assent signed by parents or legal representatives of the subject.
* Not previously enrolled in this trial.

Exclusion Criteria

* Subject with serum creatinine level ≥ 2 mg/L at inclusion.
* Subject receiving (or planned to receive) haemofiltration, extracorporeal membrane oxygenation, hemodialysis or peritoneal dialysis, molecular adsorbent recirculating system or any other exchange technique.
* Subject receiving (or planned to receive) body cooling.
* Subject death is deemed imminent and inevitable.
* Reporting of first dosing advice (based on blood sampling) is not possible within 28 hours (\*) after start treatment.
* The subject is known or suspected to be pregnant.
* The subject has a known allergy to the specific beta-lactam antibiotic.

(\*) The first (a posteriori) dose calculation and dose adjustment if necessary, is performed within a maximum timeframe of 28 hours after start of treatment (i.e. maximum timeframe to first dose adjustment).
Minimum Eligible Age

0 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Evelyn Dhont, Dr.

Role: PRINCIPAL_INVESTIGATOR

Ghent University Hospital, Princess Elisabeth Children's Hospital

Locations

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Ghent University Hospital

Ghent, , Belgium

Site Status

Countries

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Belgium

Central Contacts

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Pieter De Cock, Prof.

Role: CONTACT

+32 9 332 29 69

Facility Contacts

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Pieter De Cock, Prof.

Role: primary

+32 9 332 29 69

Other Identifiers

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2024-516447-12-00

Identifier Type: CTIS

Identifier Source: secondary_id

ONZ-2024-0295

Identifier Type: -

Identifier Source: org_study_id

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