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Trial registered on ANZCTR
Registration number
ACTRN12618001082291
Ethics application status
Approved
Date submitted
11/06/2018
Date registered
28/06/2018
Date last updated
28/06/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Preventing paediatric middle ear Ventilation Tube Obstruction with topical ciprofloxacin (PreVenT-O) : a randomised controlled trial
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Scientific title
Preventing paediatric middle ear Ventilation Tube Obstruction with topical ciprofloxacin (PreVenT-O) : a randomised controlled trial
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Secondary ID [1]
295165
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
PreVenT-O
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Otitis media with effusion
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Recurrent acute otitis media
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Postoperative otorrhoea
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Postoperative grommet blockage
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Condition category
Condition code
Ear
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0
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Other ear disorders
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Infection
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1: 5 drops of Ciprofloxacin 0.3% topical ear drops intraoperatively (double-blind arm) This is done by a research nurse.
Arm 2: 5 drops of Ciprofloxacin 0.3% topical ear drops intraoperatively + 5 drops of Ciprofloxacin 0.3% topical ear drops twice a day for 5 days postoperatively, given by the parent (assessor-blind arm) Bottles are returned on the postoperative visit. They will also be questioned about their compliance.
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Intervention code [1]
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Prevention
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Comparator / control treatment
Control: no drops/intervention will be given intraoperatively or postoperatively (double-blind arm)
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Control group
Active
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Outcomes
Primary outcome [1]
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Otorrhoea/discharge through grommet through otoscopy
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Assessment method [1]
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Timepoint [1]
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6 weeks postoperatively
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Primary outcome [2]
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Ventilation tube occlusion via tympanometry (b-low tymps) + otoscopy
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Assessment method [2]
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Timepoint [2]
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6 weeks postoperatively
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Secondary outcome [1]
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Parent reported QoL measure (Otitis Media Outcome - 22)
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Assessment method [1]
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Timepoint [1]
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Baseline i.e. date of surgery and at 6 weeks postoperatively
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Secondary outcome [2]
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Parent reported presence of discharge (subjective)
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Assessment method [2]
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Timepoint [2]
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within the first 2 postoperative weeks
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Secondary outcome [3]
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Presence of middle ear effusion and effusion type via otomicroscopy assessed by surgeon
Serous effusion - more than 50% thin clear/straw-coloured fluid
Mucoid - more than 50% thick clear/straw-coloured fluid
Purulent - pus-containing effusion
No effusion - no effusion
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Assessment method [3]
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Timepoint [3]
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At time of operation
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Secondary outcome [4]
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Presence or absence of Tympanic Membrane Bleeding via otomicroscopy assessed by surgeon
No/minimal bleeding - drops of blood not requiring suction at myringotomy incision site
Moderate bleeding - blood requiring suction covering up to 50% of Tympanic Membrane
Severe bleeding - blood requiring suction covering more than 50% of Tympanic Membrane
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Assessment method [4]
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Timepoint [4]
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At time of operation
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Eligibility
Key inclusion criteria
Undergoing bilateral grommet surgery for either:
- recurrent acute otitis media (greater than 4 episodes of AOM in 6 months, or greater than 6 in 12 months)
- chronic otitis media with effusion (middle ear effusion lasting for more than 3 months)
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Minimum age
No limit
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Maximum age
17
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
- allergy to quinolone based antibiotics
- recent use of antibiotics (within 7 days of surgery)
- failure to gain consent to participate in the study
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Study design
Purpose of the study
Prevention
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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)
Sequentially numbered sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by shuffling of identical sealed opaque envelopes 4 times
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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 assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The comparisons of interest are between Arm 1 and control as well as Arm 2 and control.
For our power analysis we assumed alpha of 0.05, beta of 0.2.
Our assumed incidence of otorrhoea/blockage for Arm 1 and 2 was 4.5% and for control was 12%.
Using a two tailed test, we determined a sample size of 621 was needed (207 in each arm). As we will be evaluating outcomes by ear, this equates to 104 participants in each arm.
Accounting for a 15% attrition rate, this equates to 120 participants per arm. Totaling 360 participants.
Demographic information of patients (age, gender, daycare attendance, pets, severity of disease, smoke exposure, parental worry score) and Intraoperative findings (Presence and absence of middle ear effusion and type, tympanic membrane bleeding) will also be assessed and used for subgroup analysis.
Our comparisons will use chi-square test for binary primary outcomes.
ANOVA or non-parametric equivalent for Qol differences between postop and baseline
Logistic regressions for correlation of baseline and intraoperative risk-factors with primary outcomes.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/07/2018
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Actual
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Date of last participant enrolment
Anticipated
30/05/2019
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Actual
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Date of last data collection
Anticipated
11/07/2019
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Actual
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Sample size
Target
360
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Casey Hospital - Berwick
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Recruitment hospital [2]
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Monash Children’s Hospital - Clayton
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Recruitment postcode(s) [1]
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3806 - Berwick
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Recruitment postcode(s) [2]
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3168 - Clayton
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Monash Health ENT Department
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Address [1]
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Monash Health ENT Department
Moorabbin Hospital
823-865 Centre Rd,
Bentleigh East VIC 3165
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Monash Health
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Address
Monash Health ENT Department
Moorabbin Hospital
823-865 Centre Rd,
Bentleigh East VIC 3165
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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Monash University
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Address [1]
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Monash University
Scenic Blvd & Wellington Road,
Clayton VIC 3800
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash Health HREC
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Ethics committee address [1]
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Human Ethics Committee Monash Health (Monash Medical Centre) 246 Clayton Rd, Clayton VIC 3168
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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26/04/2018
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Approval date [1]
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25/05/2018
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Ethics approval number [1]
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HREC/18/MonH/182
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Summary
Brief summary
Research aims: The aims of this trial is to assess the efficacy and rationale for routine topical antibiotic (Ciprofloxacin) for the prevention of grommet obstruction and otorrhoea in grommet surgery (myringotomy and ventilation tube placement) Hypothesis: That a single intraoperative dose of topical ciprofloxacin is as effective as a 5-day postoperative course for prophylaxis of two post-operative complications of paediatric grommet surgery when compared against no prophylaxis. That factors such as age, indication for surgery, number of previous grommets and intraoperative middle ear status are correlated with developing post-operative complications. That there is a significant patient reported quality of life benefit in prophylaxis compared to no prophylaxis. Participants: 360 paediatric patients (17 and under), who are undergoing bilateral myringotomy and ventilation tube placement, with a diagnosis of otitis media with effusion for at least 3 months or recurrent acute otitis media. Methods: 360 participants will be randomised to three groups. (1) Control group, receiving no intervention. (2) Single dose group, receiving one intraoperative dose of topical ciprofloxacin and no postoperative doses. (3) Multi dose group, receiving one intraoperative dose of ciprofloxacin and a 5day postoperative course of topical ciprofloxacin (2 doses daily) Measured outcomes: (1) Incidence of ventilation tube obstruction at 6 weeks diagnosed by otoscopy and tympanometry. (2) Incidence of ventilation tube otorrhoea at 2 weeks and 6 weeks by otoscopy. (3) Difference in validated disease specific QOL(OMO22) at date of surgery and 6 weeks. (4) Difference in audiometry preop and 6 weeks postop.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/375306-PreVenT-O - Patient Information and Consent Form.pdf
(Participant information/consent)
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Attachments [2]
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/AnzctrAttachments/375306-RES-18-0000-175A HREC Review Only Final Approval Letter[9781].pdf
(Ethics approval)
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Attachments [3]
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/AnzctrAttachments/375306-PreVenT-O - Study Protocol v1.1.pdf
(Protocol)
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Contacts
Principal investigator
Name
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Dr Debra Phyland
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Address
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ENT Building
Moorabbin Hospital
P.O. Box 72, Rear
867 Centre Road
Bentleigh East VIC 3165
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Country
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Australia
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Phone
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+61 03 9928 8277
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Fax
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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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Debra Phyland
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Address
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ENT Building
Moorabbin Hospital
P.O. Box 72, Rear
867 Centre Road
Bentleigh East VIC 3165
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Country
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Australia
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Phone
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+61 03 9928 8277
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Fax
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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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Charles Giddings
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Address
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ENT Building
Moorabbin Hospital
P.O. Box 72, Rear
867 Centre Road
Bentleigh East VIC 3165
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Country
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Australia
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Phone
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+61 03 9928 8799
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Fax
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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
Source
Title
Year of Publication
DOI
Embase
A randomised clinical trial of single or extended dosing ciprofloxacin versus no intervention for prevention of ventilation tube otorrhoea and obstruction (PreVenTO2).
2022
https://dx.doi.org/10.1111/coa.13887
N.B. These documents automatically identified may not have been verified by the study sponsor.
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