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Trial registered on ANZCTR
Registration number
ACTRN12607000301460
Ethics application status
Approved
Date submitted
5/06/2007
Date registered
5/06/2007
Date last updated
21/01/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
The effects of nebulised N-acetylcysteine on sputum quality and diagnostic yield: a randomised, controlled clinical trial
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Scientific title
A randomised clinical trial to compare the efficacy of nebulized N-acetylcysteine and normal saline in improving sputum quality and diagnostic yield in patients with chest infections.
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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:
Sputum quality, chest infections
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Condition category
Condition code
Respiratory
1939
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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
Single dose of 5 ml (200mg/ml) of nebulized N-acetylcysteine (intervention).
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Intervention code [1]
1804
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Diagnosis / Prognosis
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Comparator / control treatment
Single dose of 5 ml of nebulized normal saline (control).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Proportion of patients producing a sputum sample deemed ‘good quality’ (presence of >25 polymorphonuclear leukocytes and <10 squamous cells per HPF [x1000 magnification field]) as identified by the microbiology laboratory technician
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Assessment method [1]
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Timepoint [1]
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Measured within 2 days of sputum being obtained.
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Primary outcome [2]
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Proportion of ‘all’ sputum samples which are ‘positive’ for a predominant organism (ie. one type of organism clearly in greater numbers than other organisms on microscopy [Gram stain] or culture)
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Assessment method [2]
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Timepoint [2]
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Measured approximately 1 week after sputum obtained.
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Primary outcome [3]
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Proportion of ‘good quality’ sputum samples which are ‘positive’ for a predominant organism (ie. one type of organism clearly in greater numbers than other organisms on microscopy [Gram stain] or culture)
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Assessment method [3]
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Timepoint [3]
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Measured approximately 1 week after sputum obtained.
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Secondary outcome [1]
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Proportion of patients for whom a change in antibiotic regimen is made as a result of the sputum microscopy and/or culture.
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Assessment method [1]
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Timepoint [1]
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Measured approximately 1 week after sputum obtained.
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Secondary outcome [2]
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Adverse effects from NAC administration eg. bronchospasm, nausea.
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Assessment method [2]
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Timepoint [2]
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Measured within 1 hour of administration of nebulised saline or N-acetyl cysteine.
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Eligibility
Key inclusion criteria
Differential diagnosis inclusive of lower respiratory tract infection as determined by the treating physician (eg. cough, fever, pleuritic chest pain, dyspnoea, decreased breath sounds, bronchial breath sounds, crackles on auscultation) ·A sputum sample is to be collected in the ED.
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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
Inability to co-operate or consent due to debility, significant illness, language barriers, altered consciousness (as determined by the ED or study staff)·Refusal to participate·Pregnancy or breast-feeding·Known allergy to NAC·Presence of significant hepatic or renal failure·Presence of other significant co-morbidities eg. HIV, immunocompromised, cystic fibrosis, bronchiectasis·CXR suggestive of TB·Recent hospital admission within the previous 14 days inclusively·Current treatment with >10mg prenisolone daily for more than 1 month inclusively
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Study design
Purpose of the study
Diagnosis
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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)
A note containing each individual patients allocation will be inside a sealed envelope inside each study pack
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer generated random numbers
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
All people invovled with this study will be blinded - patients, people administering the treatment, people assessing the outcomes (eg. adverse events, microscopy) and people analysing the results. Only when all results have been analysed will the randomisation code be broken and the nature of the drug administration will be revealed.
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2007
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Actual
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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
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Sample size
Target
190
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
2473
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3084
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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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Austin Health
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Address [1]
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145 Studley Road, Heidelberg, Victoria, 3084
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Austin Health
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Address
145 Studley Road, Heidelberg, Victoria, 3084
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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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nil
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Austin health
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Ethics committee address [1]
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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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Approval date [1]
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20/08/2007
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Ethics approval number [1]
3872
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Summary
Brief summary
We believe that the use of N-acetylcysteine (a known mucolytic) will be useful in improving the diagnostic yield of sputum culture. If this hypothesis is proven, this agent can be recommend for this purpose.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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A/Prof David Taylor
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Address
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Emergency Department
Austin Hospital
Studley Road
Heidelberg, VIC 3084
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Country
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Australia
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Phone
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+61 3 9496 4883
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Fax
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03 9496 3380
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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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A/Prof David Taylor
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Address
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Emergency Department
Austin Hospital
Studley Road
Heidelberg VIC 3084
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Country
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Australia
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Phone
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+61 3 9496 4883
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Fax
1921
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03 9496 3380
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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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