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Trial registered on ANZCTR
Registration number
ACTRN12606000509561
Ethics application status
Approved
Date submitted
23/03/2006
Date registered
7/12/2006
Date last updated
30/03/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Antibiotics for acute bronchitis
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Scientific title
Treatment of acute bronchitis in general practice: A double blind RCT to determine the effectiveness of 500 mg amoxycillin versus placebo in reducing the duration of cough and severity of symptoms
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Secondary ID [1]
288880
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
ABFAB
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute bronchitis
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Condition category
Condition code
Respiratory
1582
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
500 mg amoxycillin capsules. Oral dose taken three times a day for 6 days.
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Intervention code [1]
945
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Treatment: Drugs
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Comparator / control treatment
Placebo (lactose containing) capsules. Oral dose taken three times a day for 6 days.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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To determine if amoxycillin, compared to placebo, improves morbidity in adult patients with 'complicated' acute bronchitis in general practice
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Assessment method [1]
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Timepoint [1]
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Comparisons at Baseline, Day 7, Day 14 and Day 28
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Secondary outcome [1]
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Medication compliance
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Assessment method [1]
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Timepoint [1]
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Day 1 - 6
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Secondary outcome [2]
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Side effects
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Assessment method [2]
3815
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Timepoint [2]
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Day 1 - 28
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Eligibility
Key inclusion criteria
1) presenting with an acute cough of less than 14 days, 2) at least one other symptom of a respiratory tract infection (sputum production, dyspnoea, wheeze, chest discomfort/pain), 3) at least one 'complicated' acute bronchitis sign (pulse rate >100, respiratory rate >25, oral temperature >38ºC, abnormal chest signs, age >55, confined to bed/very unwell, co-morbidity), 4) have read the patient information sheet and provided written consent, 5) able and willing to follow study requirements.
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Minimum age
18
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) a concurrent chronic respiratory illness that requires ongoing treatment, 2) antibiotics in the previous 3 weeks, 3) immunocompromised, 4) allergic to amoxycillin, penicillin, cephalospirins or beta-lactams, 5) lactose intolerant, 6) community acquired pneumonia, 7) bordatella pertussis.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Capsules containing either amoxycillin or placebo prepared by a hospital pharmacist. Capsules packed in identical vials with a code number according to the randomisation list.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer-generated list of random numbers in permuted blocks with variable block sizes provided by an independent statistician.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
The patients nor the examining physicians or co-ordinating and data analysis trial staff know which treatment has been allocated until database close.
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistics will be used to determine the comparability of the treatment groups for baseline patient demographic or characteristics. Count data (such as duration of cough, number of days coughing up phlegm and number of days with a sore throat etc) will be analysed using Poisson Generalised Estimating Equations (GEE) to allow for clustering of patients within doctors. Binary outcomes (such as seen GP for past cough and antibiotics for previous cough etc.) will be analysed using binomial Generalized Estimating Equations (GEE). Normally distributed data (such as frequency of cough and how well they felt today etc from visual analogue scales (VAS)) will be analysed using mixed model analysis of variance. Adjustments for confounders for patient age, gender, co-morbidities and chest signs at study entry and possible patient characteristic imbalances will be made. All analyses will be on an intention to treat basis and the significance level set at 0.05.
Subgroup analysis will be performed on the following:
- Chest signs (vs all)
- All patients >55 yrs (vs all)
- Current smokers (vs all)
- CRP greater than 30 mg/L (vs all)
Adjustments will be made in the analyses to account for contributing confounders of patient age, gender, co-morbidities and chest signs at study entry and possible patient characteristic imbalances.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2005
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Actual
26/07/2005
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Date of last participant enrolment
Anticipated
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Actual
10/07/2007
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
574
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council of Australia - Project Grant 299032
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Address [1]
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GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Adelaide
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Address
North Terrace
Adelaide SA 5005
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
1523
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Country [1]
1523
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Adelaide Human Research Ethics Committee
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Ethics committee address [1]
3192
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
3192
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Approval date [1]
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29/06/2005
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Ethics approval number [1]
3192
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H-74-2003
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Ethics committee name [2]
3193
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Children, Youth and Women's Health Service Research Ethics Committee
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Ethics committee address [2]
3193
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Ethics committee country [2]
3193
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Australia
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Date submitted for ethics approval [2]
3193
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Approval date [2]
3193
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07/11/2005
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Ethics approval number [2]
3193
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REC1737
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Ethics committee name [3]
3194
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RACGP National Research and Evaluation Ethics Committee
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Ethics committee address [3]
3194
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Ethics committee country [3]
3194
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Australia
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Date submitted for ethics approval [3]
3194
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Approval date [3]
3194
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30/06/2005
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Ethics approval number [3]
3194
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NREEC 05/02
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Summary
Brief summary
Acute bronchitis is the 5th most frequent reason to visit a general practitioner (GP), often leading to an antibiotic prescription even though guidelines advise that the infective organism is usually viral. Patient factors are partially responsible for these prescriptions but research indicates that GPs are inconsistent in their labelling of acute bronchitis and may feel the need to use antibiotics “just in case”. Studies indicate that, overall, patients with acute bronchitis may experience only a marginal benefit from antibiotic treatment, and this benefit may be offset by potential side effects. A recent Cochrane systematic review suggests that some patients may benefit from antibiotics. Based on clinical symptoms, signs and investigations, we think there may be two groups of patients with acute bronchitis - ‘uncomplicated’ and ‘complicated’- the former not requiring antibiotics and the latter, associated with poorer outcomes, who might benefit from their use. By identifying those sub-groups, GPs could be more certain about who to treat (and therefore who not to treat) leading to more rational and cost effective prescribing without compromising patient care. This is a double blind study which means that the patients have been randomly assigned to recieve either amoxycillin or placebo capsules for 6 days, and neither the patients nor the physicians or trial staff know which treatment has been allocated until database close.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Nigel Stocks
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Address
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Discipline of General Practice
University of Adelaide
North Terrace
Adelaide SA 5005
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Country
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Australia
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Phone
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+61 8 8313 3462
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Fax
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+61 8 8313 3511
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Email
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[email protected]
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Contact person for public queries
Name
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Nigel Stocks
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Address
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Discipline of General Practice
University of Adelaide
North Terrace
Adelaide SA 5005
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Country
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Australia
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Phone
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+61 8 8313 3462
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Fax
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+61 8 8313 3511
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Email
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[email protected]
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Contact person for scientific queries
Name
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Nigel Stocks
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Address
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Discipline of General Practice
University of Adelaide
North Terrace
Adelaide SA 5005
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Country
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Australia
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Phone
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+61 8 8313 3462
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Fax
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+61 8 8313 3511
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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