Preoperative Antibiotics Study - Full Text View

Sponsor:	Children's Hospital of Pittsburgh
Information provided by:	Children's Hospital of Pittsburgh
ClinicalTrials.gov Identifier:	NCT00760006

Purpose

The primary objective of this study is to determine the efficacy of administering a single dose of preoperative antibiotics to prevent complications in patients undergoing primary closure of a cleft secondary palate. Secondary objective of this study is to evaluate the effects of preoperative antibiotics administered on post operative outcome following primary closure of cleft secondary palate. The study aims to assess the efficacy of prophylactic antibiotics in cleft surgery to

decrease the incidence of surgical sight infections
speed the progression of postoperative healing
improve the final quality of wound healing achieved
decrease the rate of palatal fistula formation

Condition	Intervention	Phase
Cleft Palates	Drug: Unasyn Other: saline solution	Phase II

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Efficacy Study
Official Title:	Efficacy of Preoperative Prophylactic Antibiotics in Preventing Complications in the Primary Repair of Cleft Palates

Resource links provided by NLM:

Genetics Home Reference related topics: Baller-Gerold syndrome Crouzon syndrome

MedlinePlus related topics: Antibiotics Cleft Lip and Palate Surgery

Drug Information available for: Sultamicillin

U.S. FDA Resources

Further study details as provided by Children's Hospital of Pittsburgh:

Primary Outcome Measures:

The study aims to assess the efficacy of prophylactic antibiotics in cleft surgery. [ Time Frame: We anticipate a minimum of less than 2 months to a maximum of 1 year for follow-up will be necessary to document either stage 1 healing or the presence of a palatal fistula in nearly all cases. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Secondary objective of this study is to evaluate the effects of preoperative antibiotics administered on post operative outcome following primary closure of cleft secondary palate. [ Time Frame: We anticipate a minimum of less than 2 months to a maximum of 1 year ] [ Designated as safety issue: No ]

Estimated Enrollment:	300
Study Start Date:	May 2008
Estimated Study Completion Date:	May 2010
Estimated Primary Completion Date:	May 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Active Comparator Unasyn® is a parenteral antibiotic that combines ampicillin with sulbactam, a beta-lactamase inhibitor. The antimicrobial coverage of Unasyn	Drug: Unasyn Subjects will receive the antibiotic or the saline placebo 30 minutes prior to the initial incision in their palatoplasty procedure. The FDA approved antibiotic used for this study is Unasyn. Unasyn is a first-line measure, used by ENT surgeons at Children's Hospital of Pittsburgh for antibiotic treatment of virtually all ear, nose and throat infections. The use of Unasyn for this study is off-label as with the majority of antibiotics used with children. Subjects will receive a one time dose of 50mg/kg prior to surgery, not to exceed a total of 2gm
2: Placebo Comparator saline placebo	Other: saline solution Subjects will receive a one time dose of 50mg/kg prior to surgery, not to exceed a total of 2gm.

Arms

Assigned Interventions

1: Active Comparator

Unasyn® is a parenteral antibiotic that combines ampicillin with sulbactam, a beta-lactamase inhibitor. The antimicrobial coverage of Unasyn

Drug: Unasyn

Subjects will receive the antibiotic or the saline placebo 30 minutes prior to the initial incision in their palatoplasty procedure. The FDA approved antibiotic used for this study is Unasyn. Unasyn is a first-line measure, used by ENT surgeons at Children's Hospital of Pittsburgh for antibiotic treatment of virtually all ear, nose and throat infections. The use of Unasyn for this study is off-label as with the majority of antibiotics used with children. Subjects will receive a one time dose of 50mg/kg prior to surgery, not to exceed a total of 2gm

2: Placebo Comparator

saline placebo

Other: saline solution

Subjects will receive a one time dose of 50mg/kg prior to surgery, not to exceed a total of 2gm.

Show Detailed Description

Eligibility

Ages Eligible for Study:	3 Months to 18 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Children diagnosed as having cleft palates undergoing palatoplasty between the ages of 3 months and 18 years will be included in this study. Palatoplasty is the current standard of care in the sequence of treatment for cleft secondary palates. Pediatric plastic surgeons work primarily with children, and have undergone extensive training during their residencies and pediatric surgical fellowships to do so. Children will be evaluated initially at the Cleft-Craniofacial Center at the Children's Hospital of Pittsburgh of UPMC, which is set up to accommodate children of all ages and their families. Approximately 300 children will be required to contribute to a meaningful analysis.

Exclusion Criteria:

All patients requiring prophylactic antibiotics for spontaneous bacterial endocarditis, with documented allergic reactions to the ampicillin-sulbactam, and with known immunodeficiencies or immunodeficiency associated syndromes, such as the 22q chromosomal deletion, will be excluded from study participation.
Selection will be based on the parent's willingness to allow their child to participate in the study.
Children already receiving antibiotics at the time of their surgery will be evaluated distinctly, though they will not be included in the antibiotic or the placebo groups

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00760006

Contacts

Contact: Joseph Losee, MD	412-692-7949	joseph.losee@chp.edu
Contact: Jennifer Szczepaniak, BS	412-692-6203	jennifer.szczepaniak@chp.edu

Locations

United States, Pennsylvania
Children's Hospital of Pittsburgh of UPMC	Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Contact: Joseph Losee, MD 412-692-7949 joseph.losee@chp.edu
Contact: Jennifer Szczepaniak, BS 412-692-6203 jennifer.szczepaniak@chp.edu

Sponsors and Collaborators

Children's Hospital of Pittsburgh

Investigators

Principal Investigator:

Joseph Losee, MD

Children's Hospital of Pittsburgh of UPMC

More Information

Publications:

1. Centers for Disease Control and Prevention (CDC). Improved National prevalence estimates for 18 selected major birth defects—Unites States, 1999-2001. MMWR Morb Mortal Wkly Rep. 2006; 54:1301-1305. 2. Chuo CB, Timmons MJ. The bacteriology of children before primary cleft lip and palate surgery. The Cleft Palate-Craniofac J. 2005; 42:272-276. 3. Mercer NSG. The use of preoperative swabs in cleft lip and palate repair [letter to the editor]. Br J Plast Surg. 2002; 55:176-177. 4. Jolleys A, Savage JP. Healing defects in cleft palate surgery-the role of infection. Br J Plast Surg. 1963; 16:134-139. 5. Lowbury EJL. Infection of Burns. Proc Soc Med. 1954; 47:231-232. 6. Jackson DM, Lowbury EJL, Topley E. Chemotherapy of Streptococcus pyogenes infection of burns. Lancet. 1951; 2:705-711. 7. McClelland RMA, Patterson TJS. The influence of penicillin on the complication rate after repair of clefts of the lip and palate. Br J Plast Surg. 1963; 16:144-145. 8. Marzoni FA, Kelly DR. Bacteraemia following cleft palate repair-a prospective study. Ann Plast Surg. 1983; 10:473-474. 9. Crawford JJ, Fischer ND. Oral and respiratory flora of individuals with normal and repaired palatal clefts. Cleft Palate J. 1971; 8:166-176.

Responsible Party:	Children's Hospital of Pittsburgh of UPMC ( Joseph E. Losee, MD, FACS, FAAP )
Study ID Numbers:	07090352
Study First Received:	September 24, 2008
Last Updated:	October 1, 2008
ClinicalTrials.gov Identifier:	NCT00760006 History of Changes
Health Authority:	United States: Institutional Review Board

Keywords provided by Children's Hospital of Pittsburgh:

cleft secondary palate
Patients undergoing primary closure of a cleft secondary palate

Additional relevant MeSH terms:

Mouth Diseases
Anti-Infective Agents
Craniofacial Abnormalities
Jaw Diseases
Stomatognathic System Abnormalities
Sultamicillin
Maxillofacial Abnormalities
Pharmacologic Actions
Musculoskeletal Abnormalities

Cleft Palate
Anti-Bacterial Agents
Musculoskeletal Diseases
Mouth Abnormalities
Therapeutic Uses
Jaw Abnormalities
Stomatognathic Diseases
Congenital Abnormalities

ClinicalTrials.gov processed this record on February 08, 2010