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Trial registered on ANZCTR
Registration number
ACTRN12615000809538
Ethics application status
Approved
Date submitted
9/07/2015
Date registered
5/08/2015
Date last updated
29/09/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Antibiotic disposition in children undergoing heart surgery
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Scientific title
Pharmacokinetics of prophylactic antibiotics in children undergoing heart surgery with cardiopulmonary bypass circuitry
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Secondary ID [1]
287064
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NIL Known
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Universal Trial Number (UTN)
U1111-1172-0310
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
children with heart disease
295558
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Cardiac surgery related infection
295619
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Condition category
Condition code
Infection
295828
295828
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0
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Studies of infection and infectious agents
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Cardiovascular
295897
295897
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0
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Other cardiovascular diseases
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Surgery
295898
295898
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0
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Other surgery
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Pharmacokinetic analysis of antibiotic disposition in children undergoing cardiac surgery with cardiopulmonary bypass. Antibiotics (cephazolin, vancomycin) are given intravenously during the procedure only. The first dose is at induction of anaesthesia. A second dose is commonly given at the conclusion of cardiopulmonary bypass. They are not continued into the postoperative period. A dosing log will be kept.
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Intervention code [1]
292294
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Not applicable
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Comparator / control treatment
This is an observational study of drug disposition in those children given routine prophylactic antibiotics
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Characterise antibiotic disposition in children undergoing cardiopulmonary bypass or on extracorporeal circuits.
Blood assays taken after drug administration will be used for a pharmacokinetic population analysis using mixed effects models. Covariate effects (age, size, renal function, surgical type, bypass duration, temperature) will be assessed in order to decrease population parameter variability.
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Assessment method [1]
295518
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Timepoint [1]
295518
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Approx 15 blood samples for assay from each individual will be taken over the duration of surgery from anaesthesia induction and into a 12 h postoperative period. Specific time points are not used for this type of analysis, but rather windows of time e.g. early samples assist determination of V; late samples (3 half lives) help determine CL. Samples will be required after interventions (e.g bypass initiation). Optimal design simulation will be used to determine the best windows for sampling
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Secondary outcome [1]
316047
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The use of simulation using computer modelling to predict therapeutic blood concentrations in a typical individual
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Assessment method [1]
316047
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Timepoint [1]
316047
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This simulation analysis will be performed once data for primary endpoint analysis is complete. We anticipate 6 months after PK analysis is complete
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Eligibility
Key inclusion criteria
children with heart disease presenting for surgery that requires extracorporeal circuits
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Minimum age
No limit
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Maximum age
18
Years
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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
refusal by parent/caregiver or child for consent
known allergy to antibiotic
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
We will relate given dose to observed drug concentration in the blood, using nonlinear mixed effects models and the computer program NONMEM. Once a structural pharmacokinetic model has been developed, we will consider incorporation of key covariates to better describe variability in observed concentrations following standard dosing in our population. We will assess our model using standard goodness of fit criterion and plots, visual predictive checks and simulation methods. Required numbers required for this population analysis remain uncertain but we anticipate approx. 50 children. This aspect is pharmacokinetics
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/12/2016
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Actual
14/08/2017
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Date of last participant enrolment
Anticipated
28/02/2018
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
17
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Final
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Recruitment outside Australia
Country [1]
7027
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New Zealand
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State/province [1]
7027
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Auckland
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Funding & Sponsors
Funding source category [1]
291622
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Charities/Societies/Foundations
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Name [1]
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Green Lane Research and Education Fund
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Address [1]
291622
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Auckland City Hospital
Cardiology Department
Level 3, Building 32
Park Road
Grafton
AUCKLAND, 1142
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Country [1]
291622
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New Zealand
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Primary sponsor type
Individual
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Name
Brian Anderson
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Address
c/o PICU
Starship Hospital
park Road Grafton Auckland 1023
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
290294
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Kirsten Finucane
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Address [1]
290294
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c/o Cardiac Services
Starship Hospital
Park Road, Grafton, Auckland 1023
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Country [1]
290294
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293153
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Health and Disability Ethic Committees
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Ethics committee address [1]
293153
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Ministry of Health Ethics Department Freyberg Building Reception – Ground Floor 20 Aitken Street Wellington 6011
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Ethics committee country [1]
293153
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New Zealand
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Date submitted for ethics approval [1]
293153
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03/08/2015
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Approval date [1]
293153
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23/09/2015
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Ethics approval number [1]
293153
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Summary
Brief summary
Prophylactic antibiotic choice and dosing during paediatric cardiac surgery using cardiopulmonary bypass remains poorly defined. Cardiac surgery should be associated with an incidence of infection (superficial and deep) < 5%. This target is not reached in many centres. One contributing factor is a lack of understanding of antibiotic pharmacokinetics during support with extracorporeal circuits. Dosing may not achieve desired concentrations in the body. Children undergoing cardiac surgery will receive routine antibiotic prophylaxis. Blood concentrations will be monitored. Population pharmacokinetic modelling will be used to determine a dosing regimen to achieve desired target concentration.
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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
58682
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Prof Brian Anderson
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Address
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c/o PICU
Starship Hospital
Park Road
Grafton
Auckland 1023
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Country
58682
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New Zealand
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Phone
58682
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+64 9 3074903
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Fax
58682
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+64 9 3078986
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Email
58682
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[email protected]
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Contact person for public queries
Name
58683
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Brian Anderson
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Address
58683
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c/o PICU
Starship Hospital
Park Road
Grafton
Auckland 1023
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Country
58683
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New Zealand
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Phone
58683
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+64 9 3074903
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Fax
58683
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+64 9 3078986
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Email
58683
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[email protected]
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Contact person for scientific queries
Name
58684
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Brian Anderson
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Address
58684
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c/o PICU
Starship Hospital
Park Road
Grafton
Auckland 1023
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Country
58684
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New Zealand
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Phone
58684
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+64 9 3074903
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Fax
58684
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+64 9 3078986
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Email
58684
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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.
Download to PDF