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Azithromycin in Patients With CF, Infected With Burkholderia Cepacia Complex

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified July 2009 by St. Michael's Hospital, Toronto.
Recruitment status was:  Active, not recruiting
Cystic Fibrosis Foundation Therapeutics
Information provided by:
St. Michael's Hospital, Toronto Identifier:
First received: March 2, 2006
Last updated: July 30, 2009
Last verified: July 2009

Pulmonary infection with Burkholderia cepacia complex (BCC) in patients with CF is often associated with a more rapid decline in lung function. Because of the resistance of BCC to many antibiotics, treatment options are often limited. New therapies to improve outcomes for patients infected with BCC are needed.

However, because of the unpredictable nature of this pulmonary infection in CF, patients with BCC infection have been excluded from many CF therapeutic trials.

Recent published trials in the United States, Australia, and the United Kingdom have all demonstrated clinical benefits from prolonged administration of azithromycin in CF. In these trials, the vast majority of patients were chronically infected with Pseudomonas aeruginosa.

Patients with BCC were excluded from the US and UK trials, and only four patients with BCC infection were enrolled in the Australian trial. Thus, the effectiveness of azithromycin in CF patients infected with BCC is largely unknown and deserves further study.

The two main ways by which azithromycin is thought to help with the chronic lung infections seen in CF are by [a] reducing inflammation and [b] direct effects on the bacteria, in particular P. aeruginosa. BCC pulmonary infection in CF is often associated with a large inflammatory response similar to or more severe than P. aeruginosa infection. If azithromycin works mainly by an anti-inflammatory mechanism, it should also be helpful in CF patients infected with BCC.

Alternatively, azithromycin could have a direct effect on BCC as seen with P. aeruginosa as the two bacteria have many similarities.

Condition Intervention Phase
Cystic Fibrosis
Drug: Azithromycin
Drug: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Phase II, Randomized, Double Blind, Placebo-Controlled Trial of Azithromycin in Patients With CF, Chronically Infected With Burkholderia Cepacia Complex

Resource links provided by NLM:

Further study details as provided by St. Michael's Hospital, Toronto:

Primary Outcome Measures:
  • Change in FEV1 in % predicted in CF study subjects treated with azithromycin compared with those CF study subjects treated with placebo. [ Time Frame: 24 weeks ]

Estimated Enrollment: 45
Study Start Date: February 2006
Estimated Study Completion Date: October 2009
Estimated Primary Completion Date: February 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Azithromycin
participants taking 500 mg tablets orally thrice weekly for 24 weeks
Drug: Azithromycin
500 mg tablets orally thrice weekly for 24 weeks
Placebo Comparator: Placebo
Participants taking 500 mg tablets orally thrice weekly for 24 weeks
Drug: Placebo
tablet orally thrice weekly for 24 weeks

  Show Detailed Description


Ages Eligible for Study:   19 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Informed consent and verbal assent as appropriate has been provided by the subject
  • Ability to comply with medication use, study visits and study procedures as judged by the site Investigator
  • Diagnosis of CF as defined by two or more clinical features of CF and a documented sweat chloride > 60 mEq/L by quantitative pilocarpine iontophoresis test or a genotype showing two well characterized disease causing mutations
  • > 18 years of age
  • Body weight > 40 kg
  • BCC present in a sputum/throat culture > 1 year prior to screening and at screening
  • FEV1 % predicted > 30% as calculated by the Knudsen reference equations
  • Room air oximetry > 88% at rest
  • Post-menarche females must be surgically sterile or using an effective form of contraception
  • Predicted to live > 1 year and clinically stable at that time of enrollment as judged by the investigator.

Exclusion Criteria:

  • History of chronic macrolide use, defined as regular macrolide antibiotic use within a three month period prior to enrollment in the study.
  • AST or ALT > 2.5 times the upper limit of normal performed at the local laboratories on two occasions prior to randomization.
  • Investigational drug use within 30 days of screening
  • History of alcohol, illicit drug or medication abuse within 1 year of screening
  • Use of intravenous antibiotics or oral antibiotics within 14 days of screening.
  • Use of low dose oral antibiotics (e.g. macrolides, tetracycline, sulfa) for acne or other conditions within 30 days of screening
  • Use of systemic corticosteroids (> 20 mg of prednisone per day) within 30 days of screening
  • Initiation of TOBI®, high dose ibuprofen, or rhDNase within 60 days of screening
  • History of lung transplantation or currently on lung transplant list
  • History of allergy to a macrolide antibiotic
  • AFB smear positive at screening suggesting current NTM infection.
  • Positive serum pregnancy test at screening (to be performed on all post-menarche females)
  • Absolute neutrophil count < 1000 performed at the local laboratories on two occasions prior to randomization
  • Creatinine > 1.5 times normal performed at the local laboratories on two occasions prior to randomization.
  • Chest x-ray changes or physical findings at screening that would compromise the safety of the patient or the quality of the study data
  • Other major organ dysfunction
  Contacts and Locations
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Please refer to this study by its identifier: NCT00298922

Canada, Ontario
St. Michael's Hospital
Toronto, Ontario, Canada, M5B1W8
Sponsors and Collaborators
St. Michael's Hospital, Toronto
Cystic Fibrosis Foundation Therapeutics
Principal Investigator: Elizabeth Tullis, MD University of Toronto
  More Information

Responsible Party: Dr. Elizabeth Tullis, St. Michael's Hospital Identifier: NCT00298922     History of Changes
Other Study ID Numbers: AZ 0003
Study First Received: March 2, 2006
Last Updated: July 30, 2009

Keywords provided by St. Michael's Hospital, Toronto:
Cystic Fibrosis
Burkholderia cepacia complex

Additional relevant MeSH terms:
Cystic Fibrosis
Pathologic Processes
Pancreatic Diseases
Digestive System Diseases
Lung Diseases
Respiratory Tract Diseases
Genetic Diseases, Inborn
Infant, Newborn, Diseases processed this record on May 22, 2017