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Trial registered on ANZCTR
Registration number
ACTRN12618000110280
Ethics application status
Approved
Date submitted
27/07/2015
Date registered
24/01/2018
Date last updated
24/01/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Beta-lactam pharmacokinetics in haematology patients with sepsis.
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Scientific title
Evaluation of pharmacokinetic and clinical outcomes with standard empiric beta-lactam antibiotic dosing strategies in patients with febrile neutropenia being treated with intensive chemotherapy for haematological malignancies, including assessment of alterations in renal clearance in the setting of sepsis.
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Secondary ID [1]
287150
0
Nil
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Universal Trial Number (UTN)
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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:
Febrile neutropenia
295709
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Haematological malignancy
295947
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Sepsis
295948
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Condition category
Condition code
Infection
295989
295989
0
0
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Studies of infection and infectious agents
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Cancer
296221
296221
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0
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Leukaemia - Acute leukaemia
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Cancer
296222
296222
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0
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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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
1. Assessment of pharmacokinetic/pharmacodynamic outcomes of beta lactam antibiotics which are prescribed in the course of standard care of neutropenic fever. Specifically, two drug levels will be collected in steady-state to calculate the time during the dosing interval for which the unbound antibiotic concentration remains above the desired MIC.
2. Assessment of clinical outcomes, including rate of resolution of infection, duration of antibiotic treatment, length of hospital stay, overall survival. The maximum period of observation will be 30 days.
3. Assessment of changes in creatinine clearance with the onset of sepsis, using timed urine collection before and after onset of fever.
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Intervention code [1]
292420
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Not applicable
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
295660
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The achievement of target serum beta-lactam concentrations as measured by the time during the dosing interval for which the unbound antibiotic concentration remains above the desired minimum inhibitory concentration (fTMIC).
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Assessment method [1]
295660
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Timepoint [1]
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Two samples collected in steady state (ie at least 24 hours after commencing antibiotic): one at mid-dosing interval and one at end of dosing interval.
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Secondary outcome [1]
316137
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Creatinine clearance at baseline and following the onset of sepsis, calculated using paired serum and 24 hour urine samples.
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Assessment method [1]
316137
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Timepoint [1]
316137
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At enrolment and again at onset of first fever.
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Secondary outcome [2]
316850
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Time to resolution of infection, defined by time to normalisation of temperature and haemodynamic parameters. This information will be collected from the patient's hospital record.
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Assessment method [2]
316850
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Timepoint [2]
316850
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Days from time of first fever. This information will be collected from the patient's hospital record.
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Secondary outcome [3]
316851
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Duration of antibiotic treatment. This information will be collected from the patient's hospital record.
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Assessment method [3]
316851
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Timepoint [3]
316851
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Days from time of initiation of antibiotic. This information will be collected from the patient's hospital record.
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Secondary outcome [4]
316852
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Duration of in-patient hospital stay. This information will be collected from the patient's hospital record.
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Assessment method [4]
316852
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Timepoint [4]
316852
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Days from time of first fever to discharge. This information will be collected from the patient's hospital record.
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Secondary outcome [5]
316853
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Overall survival. This information will be collected from the patient's hospital record.
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Assessment method [5]
316853
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Timepoint [5]
316853
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30 days from time of first fever. This information will be collected from the patient's hospital record.
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Eligibility
Key inclusion criteria
Able to provide written informed consent;
Age equal to or greater than 18 years;
Receiving intensive chemotherapy for acute leukaemia or high-grade lymphoma
-Intensive chemotherapy is defined as a treatment regimen that is expected to produce neutropenia (absolute neutrophil count <1x10^9/L) for at least 7 days duration.
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Minimum age
18
Years
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Maximum age
No limit
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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
Inadequate venous access to facilitate sample collection;
Pre-existing renal failure (eGFR <60mL/min);
Known allergy/ hypersensitivity to all study beta-lactam antibiotics;
Prior anaphylaxis to penicillin;
Pregnancy.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data analysis is complete
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
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Actual
6/08/2015
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Date of last participant enrolment
Anticipated
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Actual
20/02/2017
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Date of last data collection
Anticipated
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Actual
20/03/2017
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Sample size
Target
100
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Accrual to date
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Final
32
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
9642
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Royal Brisbane & Womens Hospital - Herston
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Recruitment postcode(s) [1]
18404
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4029 - Herston
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Funding & Sponsors
Funding source category [1]
291719
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Charities/Societies/Foundations
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Name [1]
291719
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RBWH Foundation
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Address [1]
291719
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Block 20 Royal Brisbane and Women’s Hospital
Butterfield St
Herston QLD 4006
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Country [1]
291719
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Australia
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Primary sponsor type
Hospital
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Name
Cancer Care Services, RBWH
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Address
Level 5
Joyce Twedell Bldg
Royal Brisbane Hospital
Butterfield St
Herston QLD 4006
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Country
Australia
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Secondary sponsor category [1]
290391
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None
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Name [1]
290391
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nil
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Address [1]
290391
0
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Country [1]
290391
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293241
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RBWH HREC
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Ethics committee address [1]
293241
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Human Research Ethics Office Level 7, Block 7 Royal Brisbane and Women's Hospital Herston Rd Herston QLD 4006
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Ethics committee country [1]
293241
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Australia
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Date submitted for ethics approval [1]
293241
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Approval date [1]
293241
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22/04/2015
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Ethics approval number [1]
293241
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HREC/15/QRBW/104
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Summary
Brief summary
The primary purpose of this study is to evaluate the pharmacokinetic and pharmacodynamic outcomes with standard beta lactam antibiotics given to patients with febrile neutropenia as a result of intensive chemotherapy. Who is it for? You may be eligible to join this study if you are aged 18 or over, and have been prescribed a course of intensive chemotherapy for acute leukaemia or high-grade lymphoma. Study details This is an observational study, so all participants will undergo the standard care prescribed to them by their treating physician. To assess outcomes, blood samples will be taken at baseline, two samples approximately 24 hours after commencement of antibiotics and at onset of fever, and one urine sample will also be taken 24 hours after onset of fever. Additional information including length of antibiotic use and hospital stay will also be noted. It is hoped that the findings of this trial will aid understanding of the distribution and levels of this class of antibiotics in the body, and their impact on outcomes in patients with febrile neutropenia as a result of intensive chemotherapy.
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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
59030
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Dr Nicholas Weber
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Address
59030
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Level 5 Joyce Twedell Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4006
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Country
59030
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Australia
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Phone
59030
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+61736468111
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Fax
59030
0
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Email
59030
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[email protected]
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Contact person for public queries
Name
59031
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Nicholas Weber
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Address
59031
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Level 5 Joyce Twedell Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4006
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Country
59031
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Australia
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Phone
59031
0
+61736468111
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Fax
59031
0
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Email
59031
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[email protected]
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Contact person for scientific queries
Name
59032
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Nicholas Weber
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Address
59032
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Level 5 Joyce Twedell Building
Royal Brisbane and Women's Hospital
Butterfield St
Herston QLD 4006
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Country
59032
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Australia
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Phone
59032
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+61736468111
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Fax
59032
0
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Email
59032
0
[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
Source
Title
Year of Publication
DOI
Embase
Evaluation of pharmacokinetic/pharmacodynamic and clinical outcomes with 6-hourly empiric piperacillin-tazobactam dosing in hematological malignancy patients with febrile neutropenia.
2019
https://dx.doi.org/10.1016/j.jiac.2019.02.014
N.B. These documents automatically identified may not have been verified by the study sponsor.
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