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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01479283
Registration number
NCT01479283
Ethics application status
Date submitted
15/11/2011
Date registered
24/11/2011
Titles & IDs
Public title
Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY)
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Scientific title
Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY): A Multi-Center International Randomized Controlled Trial Comparing Alternative Antibiotic Regimens in Patients Undergoing Tumor Resections With Endoprosthetic Replacements
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Secondary ID [1]
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GHRT01
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Universal Trial Number (UTN)
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Trial acronym
PARITY
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Infection
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Bone Neoplasms
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Condition category
Condition code
Cancer
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Bone
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Cancer
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Children's - Other
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - 24-Hour Prophylactic Cefazolin* Antibiotic Regimen
Treatment: Drugs - 5-Days Prophylactic Cefazolin* Antibiotic Regimen
Active comparator: Short-Arm Antibiotic Regimen - Intervention: 24-Hour Prophylactic Cefazolin\* Antibiotic Regimen
\*or another cephalosporin with equivalent gram-positive coverage in centers where cefazolin is not routinely used or not approved for use
Experimental: Long-Arm Antibiotic Regimen - Intervention: 5-Days Prophylactic Cefazolin\* Antibiotic Regimen
\*or another cephalosporin with equivalent gram-positive coverage in centers where cefazolin is not routinely used or not approved for use
Treatment: Drugs: 24-Hour Prophylactic Cefazolin* Antibiotic Regimen
Pre-Operative Antibiotic Regimen: Patients will receive 2g (or a weight-based dose based on 100mg/kg/day with a maximum single dose of 2g if \< 18 years old) of IV cefazolin within 60 minutes prior to the procedure. No other pre-operative antibiotics will be administered.
Intra-Operative Antibiotic Regimen: Patients will receive 2g (or a weight-based dose based on 100mg/kg/day with a maximum single dose of 2g if \< 18 years old) of IV cefazolin every 3-4 hours. No other intra-operative antibiotics will be administered.
Post-Operative Antibiotic Regimen: Patients will receive 2g (or a weight-based dose based on 100mg/kg/day with a maximum single dose of 2g if \< 18 years old) of IV cefazolin every 8 hours for 24 hours followed by IV saline for 4 days. No other post-operative antibiotics will be administered.
Treatment: Drugs: 5-Days Prophylactic Cefazolin* Antibiotic Regimen
Pre-Operative Antibiotic Regimen: Patients will receive 2g (or a weight-based dose based on 100mg/kg/day with a maximum single dose of 2g if \< 18 years old) of IV cefazolin within 60 minutes prior to the procedure. No other pre-operative antibiotics will be administered.
Intra-Operative Antibiotic Regimen: Patients will receive 2g (or a weight-based dose based on 100mg/kg/day with a maximum single dose of 2g if \< 18 years old) of IV cefazolin every 3-4 hours. No other intra-operative antibiotics will be administered.
Post-Operative Antibiotic Regimen: Patients will receive 2g (or a weight-based dose based on 100mg/kg/day with a maximum single dose of 2g if \< 18 years old) of IV cefazolin every 8 hours for 5 days. No other post-operative antibiotics will be administered.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Surgical Site Infections
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Assessment method [1]
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the development of a surgical site infection according to the criteria established by the Center for Disease Control (CDC)
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Timepoint [1]
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1 year
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Secondary outcome [1]
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Functional Outcome and Quality of Life
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Assessment method [1]
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as measured by the Musculoskeletal Tumor Society (MSTS) functional score (1987 and 1993 versions) and the Toronto Extremity Salvage Score (TESS) questionnaires
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Timepoint [1]
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1 year
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Secondary outcome [2]
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Antibiotic-Related Complications
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Assessment method [2]
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examples of antibiotic-related complications include gastrointestinal infections, fungal infections, etc.
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Timepoint [2]
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1 year
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Secondary outcome [3]
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Rate of Re-Operation
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Assessment method [3]
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re-operation may be required if patients develop a surgical site infection
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Timepoint [3]
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1 year
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Secondary outcome [4]
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Oncologic Recurrence and/or Metastases
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Assessment method [4]
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0
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Timepoint [4]
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1 year
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Secondary outcome [5]
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Mortality
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Assessment method [5]
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Timepoint [5]
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1 year
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Eligibility
Key inclusion criteria
* primary bone malignancies or aggressive benign bone tumors of the femur or tibia, soft-tissue sarcomas which have invaded the femur or tibia, or oligometastatic bone disease of the femur or tibia in a patient expected to live at least one year post-operatively; and
* treatment by surgical excision and endoprosthetic replacement of the femur or tibia.
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Minimum age
12
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
* current known Methicillin-resistant Staphylococcus Aureus (MRSA) colonization;
* current known Vancomycin Resistant Enterococcus (VRE) colonization;
* documented anaphylaxis or angioedema to penicillin or cefazolin (Ancef);
* current surgical procedure is a revision surgery for implant failure or infection;
* prior local infection within the surgical field of the affected limb;
* current known immunologically-deficient disease conditions (not including recent chemotherapy);
* known renal insufficiency with estimated creatinine clearance (eGRF) of less than 54 mL/min;
* reconstruction to include structural allograft;
* enrolled in a competing study; and
* weight of less than or equal to 45 kg (for sites using cefuroxime only).
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/01/2013
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/03/2021
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Sample size
Target
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Accrual to date
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Final
602
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
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5000 - Adelaide
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Recruitment outside Australia
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United States of America
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State/province [1]
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Arkansas
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United States of America
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California
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United States of America
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Connecticut
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United States of America
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Florida
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United States of America
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Georgia
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United States of America
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Iowa
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United States of America
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Maryland
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Massachusetts
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Minnesota
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Missouri
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New Hampshire
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United States of America
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New York
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United States of America
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Ohio
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Oregon
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Pennsylvania
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Tennessee
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Wisconsin
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Argentina
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Buenos Aires
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Austria
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Graz
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Brazil
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Porto Alegre
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Brazil
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São Paulo
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Canada
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Alberta
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Canada
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British Columbia
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Canada
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Ontario
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Canada
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Quebec
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Egypt
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Cairo
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India
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Delhi
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Netherlands
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South Holland
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Netherlands
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Groningen
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Singapore
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Singapore
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South Africa
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Pietermaritzburg
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Spain
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Barcelona
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Funding & Sponsors
Primary sponsor type
Other
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Name
McMaster University
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Orthopedic Research and Education Foundation
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Other collaborator category [2]
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Other
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Name [2]
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The Physicians' Services Incorporated Foundation
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Other collaborator category [3]
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Other
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Name [3]
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Canadian Cancer Society (CCS)
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Government body
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Name [4]
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Canadian Institutes of Health Research (CIHR)
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Ethics approval
Ethics application status
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Summary
Brief summary
The Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) trial is the first ever international multi-center randomized controlled trial in bone cancer surgery. In order to avoid amputation for bone cancer in the leg, complex limb-saving operations are performed. However, infections with devastating complications following surgery are common. Surgeons from across the world will randomize patients to receive either short- or long-duration antibiotic regimens after surgery with the goal of identifying the best regimen to reduce these infections.
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Trial website
https://clinicaltrials.gov/study/NCT01479283
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Trial related presentations / publications
Hasan K, Racano A, Deheshi B, Farrokhyar F, Wunder J, Ferguson P, Holt G, Schwartz H, Petrisor B, Bhandari M, Ghert M. Prophylactic antibiotic regimens in tumor surgery (PARITY) survey. BMC Musculoskelet Disord. 2012 Jun 7;13:91. doi: 10.1186/1471-2474-13-91. Ghert M, Deheshi B, Holt G, Randall RL, Ferguson P, Wunder J, Turcotte R, Werier J, Clarkson P, Damron T, Benevenia J, Anderson M, Gebhardt M, Isler M, Mottard S, Healey J, Evaniew N, Racano A, Sprague S, Swinton M, Bryant D, Thabane L, Guyatt G, Bhandari M; PARITY Investigators. Prophylactic antibiotic regimens in tumour surgery (PARITY): protocol for a multicentre randomised controlled study. BMJ Open. 2012 Nov 28;2(6):e002197. doi: 10.1136/bmjopen-2012-002197. Print 2012. Racano A, Pazionis T, Farrokhyar F, Deheshi B, Ghert M. High infection rate outcomes in long-bone tumor surgery with endoprosthetic reconstruction in adults: a systematic review. Clin Orthop Relat Res. 2013 Jun;471(6):2017-27. doi: 10.1007/s11999-013-2842-9. Epub 2013 Feb 12. Evaniew N, Nuttall J, Farrokhyar F, Bhandari M, Ghert M. What are the levels of evidence on which we base decisions for surgical management of lower extremity bone tumors? Clin Orthop Relat Res. 2014 Jan;472(1):8-15. doi: 10.1007/s11999-013-3311-1. Epub 2013 Oct 1. Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) Investigators; Ghert M, Schneider P, Guyatt G, Thabane L, Velez R, O'Shea T, Randall RL, Turcotte R, Wilson D, Wunder JS, Baptista AM, Cheng EY, Doung YC, Ferguson PC, Giglio V, Hayden J, Heels-Ansdell D, Khan SA, Sampath Kumar V, McKay P, Miller B, van de Sande M, Zumarraga JP, Bhandari M. Comparison of Prophylactic Intravenous Antibiotic Regimens After Endoprosthetic Reconstruction for Lower Extremity Bone Tumors: A Randomized Clinical Trial. JAMA Oncol. 2022 Mar 1;8(3):345-353. doi: 10.1001/jamaoncol.2021.6628. Schneider P, Heels-Ansdell D, Thabane L, Ghert M; PARITY Investigators. Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY): a multi-center randomized controlled study comparing alternative antibiotic regimens in patients undergoing tumor resections with endoprosthetic replacements-a statistical analysis plan. Trials. 2021 Mar 22;22(1):223. doi: 10.1186/s13063-021-05147-2. Gazendam A, Bozzo A, Schneider P, Giglio V, Wilson D, Ghert M. Recruitment patterns in a large international randomized controlled trial of perioperative care in cancer patients. Trials. 2021 Mar 20;22(1):219. doi: 10.1186/s13063-021-05149-0.
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Public notes
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Contacts
Principal investigator
Name
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Michelle Ghert, MD, FRCSC
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Address
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McMaster University
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01479283