Impact of Three Probabilistic Antibiotic Therapy on Digestive Microbiota and Colonization With Multi-resistant Bacteria

NCT ID: NCT07058415

Last Updated: 2025-07-10

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

NA

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-30

Study Completion Date

2027-05-31

Brief Summary

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In the event of suspected osteoarticular material infection (OAMI), broad-spectrum probabilistic antibiotic therapy is recommended immediately after revision surgery. There are no efficacy data to suggest that any particular to favour any particular molecule. However, the choice may depend on the impact on the microbiota and on Enterobacteriaceae colonization with multi-resistant Enterobacteriaceae. Our aim is to evaluate three different strategies efepime+daptomycin C+D, piperacillin-tazobactam+daptomycin (PT+D) and ceftobiprole (CFB).

Detailed Description

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Conditions

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Osteoarticular Material Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Comparative, randomized, multicentric clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Céfépime + Daptomycine

First stool sample taken the day before starting antibiotic therapy. Second stool sample on the fourth post-operative day (D5). Third stool sample taken 28 days after the end of antibiotic treatment (DX+28).

Group Type ACTIVE_COMPARATOR

Stool sample 1

Intervention Type OTHER

Stool sampling at D0 for having baseline reference

Stool sample 2

Intervention Type OTHER

Stool sampling at D5 to study the impact of antibiotics on microbiota

Stool sample 3

Intervention Type OTHER

Stool sampling at DX+28 to study the impact of antibiotics on microbiota

Pipéracilline-Tazobactam + Daptomycine

First stool sample taken the day before starting antibiotic therapy. Second stool sample on the fourth post-operative day (D5). Third stool sample taken 28 days after the end of antibiotic treatment (DX+28).

Group Type ACTIVE_COMPARATOR

Stool sample 1

Intervention Type OTHER

Stool sampling at D0 for having baseline reference

Stool sample 2

Intervention Type OTHER

Stool sampling at D5 to study the impact of antibiotics on microbiota

Stool sample 3

Intervention Type OTHER

Stool sampling at DX+28 to study the impact of antibiotics on microbiota

Ceftobiprole

First stool sample taken the day before starting antibiotic therapy. Second stool sample on the fourth post-operative day (D5). Third stool sample taken 28 days after the end of antibiotic treatment (DX+28).

Group Type EXPERIMENTAL

Stool sample 1

Intervention Type OTHER

Stool sampling at D0 for having baseline reference

Stool sample 2

Intervention Type OTHER

Stool sampling at D5 to study the impact of antibiotics on microbiota

Stool sample 3

Intervention Type OTHER

Stool sampling at DX+28 to study the impact of antibiotics on microbiota

Interventions

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Stool sample 1

Stool sampling at D0 for having baseline reference

Intervention Type OTHER

Stool sample 2

Stool sampling at D5 to study the impact of antibiotics on microbiota

Intervention Type OTHER

Stool sample 3

Stool sampling at DX+28 to study the impact of antibiotics on microbiota

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Indication for prosthetic revision (PTG, PUC, PTH or hip hemiarthroplasty, PTE) or internal osteosynthesis with suspicion of IOAM following the opinion of a Réunion de concertation Pluridisciplinaire (RCP) on complex osteoarticular infections
* Normal CPK level according to laboratory standard
* Social security affiliation
* Signature of informed consent
* Negative pregnancy test for women of childbearing age.

Exclusion Criteria

* Antibiotic therapy in the 3 months prior to inclusion
* Clinical or radiological signs making HAI highly probable: scar discharge and/or peri-scar cellulitis fistula or abscess, bacteremia
* positive bacterial culture from joint puncture or biopsy prior to revision
* Chronic inflammatory bowel disease.
* Previous surgical resection of small intestine or colon.
* Hypersensitivity to daptomycin or any of its excipients.
* Hypersensitivity to cefepime or any of its excipients or to other beta-lactamins.
* Hypersensitivity to piperacillin+tazobactam or to any of the excipients or to other beta-lactamines.
* Hypersensitivity to ceftobiprole or to any of the excipients or to other beta-lactamines.
* Renal insufficiency with GFR \< 50ml/min/1.73 m2 (CKD-EPI).
* Treatment with bosentan.
* Treatment with probenecid.
* Pre-existing seizure disorder.
* Contraindication to L-arginine, acidosis, hyperkalemia that cannot be corrected.
* Treatment with HMG-CoA reductase inhibitors.
* Treatment with statins (pitavastin, pravastatin, rosuvastatin) or glyburide.
* Patients in a medical emergency.
* Pregnant or breast-feeding women.
* Patient participating in another ongoing trial.
* Mental state rendering the patient incapable of understanding this research.
* Patient deprived of liberty by administrative or judicial decision.
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 Antibes

Antibes, , France

Site Status

Ch Cannes

Cannes, , France

Site Status

Ch Grasse

Grasse, , France

Site Status

CHU de NICE

Nice, , France

Site Status

Countries

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France

Central Contacts

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Johan COURJON

Role: CONTACT

0492035877

Irit TOUITOU

Role: CONTACT

Facility Contacts

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Sonia DJEDID

Role: primary

Nathalie DOUX

Role: primary

Geneviève GOZZERINO

Role: primary

Irit TOUITOU

Role: primary

Other Identifiers

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22-CONS-01

Identifier Type: -

Identifier Source: org_study_id

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