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Patients Response to Early Switch To Oral:Osteomyelitis Study (PRESTO:Osteo)

This study is currently recruiting participants.
Verified March 2017 by Julio Ramirez, University of Louisville
Sponsor:
ClinicalTrials.gov Identifier:
NCT02099240
First Posted: March 28, 2014
Last Update Posted: March 24, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Collaborators:
James Graham Brown Cancer Center
University of Louisville
Information provided by (Responsible Party):
Julio Ramirez, University of Louisville
  Purpose

Based on the current literature, investigators hypothesize that patients with osteomyelitis who are treated with the standard approach of intravenous antibiotics for the full duration of therapy will have the same clinical outcomes as patients treated with the experimental approach of intravenous antibiotics with early switch to oral antibiotics.

The primary objective of this study is to compare patients with osteomyelitis treated with the standard approach of intravenous antibiotics for the full duration of therapy versus patients treated with intravenous antibiotics with an early switch to oral antibiotics in relation to clinical outcomes at 12 months after discontinuation of antibiotic therapy. Secondary objectives of the study include the evaluation of adverse events related to the use of antibiotics as well as the cost of care evaluated from the hospital perspective.


Condition Intervention Phase
Osteomyelitis Drug: oral antibiotics Procedure: intravenous antibiotics Early Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Prospective Randomized Study to Compare Clinical Outcomes in Patients With Osteomyelitis Treated With Intravenous Antibiotics Versus Intravenous Antibiotics With an Early Switch to Oral Antibiotics

Resource links provided by NLM:


Further study details as provided by Julio Ramirez, University of Louisville:

Primary Outcome Measures:
  • Clinical Failures [ Time Frame: 1 month ]
    Clinical failure will be defined as clinical or laboratory evidence of infection collected from the patient's medical record documents.


Secondary Outcome Measures:
  • Evaluation of adverse events related to the use of antibiotics [ Time Frame: 1 month ]
    Antibiotic--‐related adverse events will be defined according to the Food and Drug Administration adverse events listed in the package insert of the antibiotic prescribed for each subject.

  • Cost of care from the hospital perspective [ Time Frame: 12 months ]
    Costs will be calculated from the hospital perspective and will include the costs of the antibiotic therapy, home healthcare (nursing--‐ and infusion--‐related), and length of hospital stay.


Estimated Enrollment: 456
Study Start Date: April 2014
Estimated Study Completion Date: September 2019
Estimated Primary Completion Date: September 2019 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Intravenous antibiotics
Intravenous antibiotics for the full duration of therapy
Procedure: intravenous antibiotics
intravenous antibiotics for the full duration of therapy, antibiotic type will be dependent on bacteria type
Other Names:
  • Amoxicillin
  • Amoxil®
  • Ampicillin
  • Omnipen®
  • Bacampicillin
  • Spectrobid®
  • Carbenicillin Indanyl
  • Pyopen®, Geogen®, Geocillin®
  • Mezlocillin
  • Mezlin®
  • Piperacillin*
  • Pipracil®
  • Ticarcillin
  • Ticar®
  • Amoxicillin-Clavulanic Acid
  • Augmentin®
  • Ampicillin-Sulbactam*
  • Unasyn®
  • Benzylpenicillin
  • Benpen®
  • Cloxacillin
  • Tegopen®, Coxapen®
  • Dicloxacillin
  • Dycill®, Dynapen®, Pathocil®
  • Methicillin
  • Staphcillin®
  • Oxacillin
  • Prostaphilin®, Bactocil®
  • Penicillin G (Benzathine, Potassium, Procaine)
  • Bicillin® C-R/L-A, Pfizerpen®, Wycellin®
  • Penicillin V
  • Pen-Veek®, Beepen-VK®
  • Piperacillin+Tazobactam*
  • Zozyn®
  • Ticarcillin+Clavulanic Acid
  • Timentin®
  • Nafcillin
  • Unipen®, Nafcil®
  • Cefaclor
  • Ceclor®, Ceclor CD®
  • Cefamandol
  • Mandol®
  • Cefonicid
  • Monocid®
  • Cefotetan
  • Cefotan®
  • Cefoxitin
  • Mefoxin®
  • Cefprozil
  • Cefzil®
  • Ceftmetazole
  • Zefazone®
  • Cefuroxime
  • Kefurox®, Zinacef®
  • Cefuroxime axetil
  • Ceftin®
  • Loracarbef
  • Lorabid®Cefdinir
  • Omnicef®
  • Ceftibuten
  • Cedax®
  • Cefoperazone
  • Cefobid®
  • Cefixime*
  • Suprax®
  • Cefotaxime*
  • Claforan®
  • Cefpodoxime proxetil
  • Vantin®
  • Ceftazidime*
  • Ceptaz®, Fortaz®, Tanicef®
  • Ceftizoxime*
  • Cefizox®
  • Ceftriaxone*
  • Rocephin®
  • Cefepime
  • Maxipime®
  • Azithromycin*
  • Zithromax®
  • Clarithromycin*
  • Biaxin®
  • Clindamycin
  • Cleocin®
  • Dirithromycin
  • Dynabac®
  • Erythromycin
  • E-mycin®, Ery-tab®, Benzamycin®
  • Lincomycin
  • Lincocin®
  • T roleandomycin
  • T ao®
  • Cinoxacin
  • Cinoxacin®
  • Ciprofloxacin*
  • Cipro®
  • Enoxacin
  • Penetrex®
  • Gatifloxacin
  • T equin®
  • Grepafloxacin
  • Levofloxacin
  • Levaquin®, Quixin®
  • Lomefloxacin
  • Maxaquin®
  • Moxifloxacin
  • A velox®
  • Nalidixic acid
  • NegGam®
  • Norfloxacin*
  • Noroxin®
  • Ofloxacin
  • Floxin®
  • Sparfloxacin
  • Zagam®
  • T rovafloxacin
  • T rovan®
  • Imipenem-Cilastatin*
  • Primaxin®
  • Meropenem
  • Merrem®
  • Aztreonam*
  • Azactam®
  • Amikacin*
  • Amikin®
  • Gentamicin
  • Garamycin®
  • Kanamycin
  • Kantrex®
  • Neomycin
  • Mycifradin®, Neo-Fradin®
  • Netilmicin
  • Netromycin®
  • Streptomycin
  • Streptomycin®
  • T obramycin*
  • Tobrex®, Nebcin®
  • Paromomycin
  • Humatin®
  • T eicoplanin
  • T argocid®
  • Vancomycin*
  • Vancocyn®, Lyphocin®
  • Demeclocycline
  • Declomycin®
  • Doxycycline
  • Doxy®, Vibra®, Vibramycin®
  • Methacycline
  • Rondomycin®
  • Minocycline
  • Minocin®
  • Oxytetracycline
  • Terramycin®
  • T etracycline
  • Sumycin®
  • Chlortetracycline
  • Mafenide
  • Sulfamylon®
  • Silver Sulfadiazine
  • SSD®, Silvadene®
  • Sulfacetamide
  • Sultrim®
  • Sulfadiazine
  • Sulfamethoxazole
  • Gantanol®
  • Sulfasalazine
  • Sulfasalazine®,Azulfidine®
  • Sulfisoxazole
  • T rimethoprim-Sulfamethoxazole
  • Bactrim®, Septra®, Cofatrim®, Primsol®
  • Sulfamethizole
  • Thiosulfil Forte®
  • Rifabutin
  • Mycobutin®
  • Rifampin
  • Rifadin®
  • Rifapentine
  • Priftin®
  • Linezolid*
  • Zyvox®
  • Quinopristin+Dalfopristin*
  • Synercid®
  • Bacitracin
  • Baci-IM
  • Chloramphenicol*
  • Chloromycetin®
  • Colistemetate
  • Coly-Mycin® M & S
  • Fosfomycin
  • Monurol®
  • Isoniazid
  • Rifamate®
  • Methenamine
  • Hiprex®, Mandelamine®
  • Metronidazol
  • Flagyl®
  • Mupirocin
  • Bactroban®
  • Nitrofurantoin
  • Macrobid®, Macrodantin®, Furantoin®
  • Nitrofurazone
  • Furacin®
  • Novobiocin
  • Albamycin®
  • Polymyxin B
  • Aerospin®
  • Spectinomycin
  • T robicin®
  • T rimethoprim
  • Proloprim®, Trimpex®
  • Colistin
  • Cycloserine
  • Capreomycin
  • Ethionamide
  • Pyrazinamide
  • Para-aminosalicyclic acid
  • Erythromycin ethylsuccinate + sulfisoxazole
Active Comparator: oral antibiotics
intravenous antibiotic therapy plus early switch to oral antibiotic therapy
Drug: oral antibiotics
intravenous antibiotics with early switch to oral antibiotics, antibiotic type will be dependent on bacteria type
Other Names:
  • Amoxicillin
  • Amoxil®
  • Ampicillin
  • Omnipen®
  • Bacampicillin
  • Spectrobid®
  • Carbenicillin Indanyl
  • Pyopen®, Geogen®, Geocillin®
  • Mezlocillin
  • Mezlin®
  • Piperacillin*
  • Pipracil®
  • Ticarcillin
  • Ticar®
  • Amoxicillin-Clavulanic Acid
  • Augmentin®
  • Ampicillin-Sulbactam*
  • Unasyn®
  • Benzylpenicillin
  • Benpen®
  • Cloxacillin
  • Tegopen®, Coxapen®
  • Dicloxacillin
  • Dycill®, Dynapen®, Pathocil®
  • Methicillin
  • Staphcillin®
  • Oxacillin
  • Prostaphilin®, Bactocil®
  • Penicillin G (Benzathine, Potassium, Procaine)
  • Bicillin® C-R/L-A, Pfizerpen®, Wycellin®
  • Penicillin V
  • Pen-Veek®, Beepen-VK®
  • Piperacillin+Tazobactam*
  • Zozyn®
  • Ticarcillin+Clavulanic Acid
  • Timentin®
  • Nafcillin
  • Unipen®, Nafcil®
  • Cefaclor
  • Ceclor®, Ceclor CD®
  • Cefamandol
  • Mandol®
  • Cefonicid
  • Monocid®
  • Cefotetan
  • Cefotan®
  • Cefoxitin
  • Mefoxin®
  • Cefprozil
  • Cefzil®
  • Ceftmetazole
  • Zefazone®
  • Cefuroxime
  • Kefurox®, Zinacef®
  • Cefuroxime axetil
  • Ceftin®
  • Loracarbef
  • Lorabid®Cefdinir
  • Omnicef®
  • Ceftibuten
  • Cedax®
  • Cefoperazone
  • Cefobid®
  • Cefixime*
  • Suprax®
  • Cefotaxime*
  • Claforan®
  • Cefpodoxime proxetil
  • Vantin®
  • Ceftazidime*
  • Ceptaz®, Fortaz®, Tanicef®
  • Ceftizoxime*
  • Cefizox®
  • Ceftriaxone*
  • Rocephin®
  • Cefepime
  • Maxipime®
  • Azithromycin*
  • Zithromax®
  • Clarithromycin*
  • Biaxin®
  • Clindamycin
  • Cleocin®
  • Dirithromycin
  • Dynabac®
  • Erythromycin
  • E-mycin®, Ery-tab®, Benzamycin®
  • Lincomycin
  • Lincocin®
  • T roleandomycin
  • T ao®
  • Cinoxacin
  • Cinoxacin®
  • Ciprofloxacin*
  • Cipro®
  • Enoxacin
  • Penetrex®
  • Gatifloxacin
  • T equin®
  • Grepafloxacin
  • Levofloxacin
  • Levaquin®, Quixin®
  • Lomefloxacin
  • Maxaquin®
  • Moxifloxacin
  • A velox®
  • Nalidixic acid
  • NegGam®
  • Norfloxacin*
  • Noroxin®
  • Ofloxacin
  • Floxin®
  • Sparfloxacin
  • Zagam®
  • T rovafloxacin
  • T rovan®
  • Imipenem-Cilastatin*
  • Primaxin®
  • Meropenem
  • Merrem®
  • Aztreonam*
  • Azactam®
  • Amikacin*
  • Amikin®
  • Gentamicin
  • Garamycin®
  • Kanamycin
  • Kantrex®
  • Neomycin
  • Mycifradin®, Neo-Fradin®
  • Netilmicin
  • Netromycin®
  • Streptomycin
  • Streptomycin®
  • T obramycin*
  • Tobrex®, Nebcin®
  • Paromomycin
  • Humatin®
  • T eicoplanin
  • T argocid®
  • Vancomycin*
  • Vancocyn®, Lyphocin®
  • Demeclocycline
  • Declomycin®
  • Doxycycline
  • Doxy®, Vibra®, Vibramycin®
  • Methacycline
  • Rondomycin®
  • Minocycline
  • Minocin®
  • Oxytetracycline
  • Terramycin®
  • T etracycline
  • Sumycin®
  • Chlortetracycline
  • Mafenide
  • Sulfamylon®
  • Silver Sulfadiazine
  • SSD®, Silvadene®
  • Sulfacetamide
  • Sultrim®
  • Sulfadiazine
  • Sulfamethoxazole
  • Gantanol®
  • Sulfasalazine
  • Sulfasalazine®,Azulfidine®
  • Sulfisoxazole
  • T rimethoprim-Sulfamethoxazole
  • Bactrim®, Septra®, Cofatrim®, Primsol®
  • Sulfamethizole
  • Thiosulfil Forte®
  • Rifabutin
  • Mycobutin®
  • Rifampin
  • Rifadin®
  • Rifapentine
  • Priftin®
  • Linezolid*
  • Zyvox®
  • Quinopristin+Dalfopristin*
  • Synercid®
  • Bacitracin
  • Baci-IM
  • Chloramphenicol*
  • Chloromycetin®
  • Colistemetate
  • Coly-Mycin® M & S
  • Fosfomycin
  • Monurol®
  • Isoniazid
  • Rifamate®
  • Methenamine
  • Hiprex®, Mandelamine®
  • Metronidazol
  • Flagyl®
  • Mupirocin
  • Bactroban®
  • Nitrofurantoin
  • Macrobid®, Macrodantin®, Furantoin®
  • Nitrofurazone
  • Furacin®
  • Novobiocin
  • Albamycin®
  • Polymyxin B
  • Aerospin®
  • Spectinomycin
  • T robicin®
  • T rimethoprim
  • Proloprim®, Trimpex®
  • Colistin
  • Cycloserine
  • Capreomycin
  • Ethionamide
  • Pyrazinamide
  • Para-aminosalicyclic acid
  • Erythromycin ethylsuccinate + sulfisoxazole

  Show Detailed Description

  Eligibility

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   18 Years to 100 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Only adult patients will be invited to participate in this trial (age ≥ 18 years). A patient will be considered a candidate to participate in this trial if the following two inclusion criteria are present:

    1. Isolation of an organism from bone culture that is susceptible to intravenous and oral antibiotics.
    2. Plus at least one of the following:

      • Evidence of local inflammatory response, manifested as local pain, edema, erythema, warmth, or drainage.
      • Evidence of systemic inflammatory response, manifested as fever, elevated C--‐reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), or white blood cell count.
  • *Osteomyelitis--‐compatible findings on plain radiograph, computed tomography, bone scan, magnetic resonance imaging, or positron emission tomography.

    • Pathology report indicative of osteomyelitis.

Exclusion Criteria:

  • A patient will not be considered as a candidate to participate in this study if the study team expects the subject to be non--‐compliant with the study follow--‐up clinic visit.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02099240


Locations
United States, Kentucky
University of Louisville Recruiting
Louisville, Kentucky, United States, 40202
Contact: Julio A Ramirez, MD    502-852-1148    jarami01@louisville.edu   
Contact: David Seligson, MD    502-852-0923    d0seli01@louisville.edu   
Sub-Investigator: Forest Arnold, DO         
Sub-Investigator: Timothy Wiemkwn, PhD         
Sub-Investigator: Robert Kelley, PhD         
Sub-Investigator: James Summersgill, PhD         
Sub-Investigator: Ruth Carrico, PhD         
Sub-Investigator: Martin Gnoni, MD         
Sub-Investigator: Julie Harting, PharmD         
Sub-Investigator: Paula Peyrani, MD         
Principal Investigator: David Seligson, MD         
Sub-Investigator: Craig Roberts, MD         
Principal Investigator: Julio Ramirez, MD         
Sponsors and Collaborators
Julio Ramirez
James Graham Brown Cancer Center
University of Louisville
Investigators
Principal Investigator: David Seligson, MD University of Louisville
Principal Investigator: Julio Ramirez, MD University of Louisville
  More Information

Publications:
Responsible Party: Julio Ramirez, Professor of Medicine, University of Louisville
ClinicalTrials.gov Identifier: NCT02099240     History of Changes
Other Study ID Numbers: 14.0185
First Submitted: March 18, 2014
First Posted: March 28, 2014
Last Update Posted: March 24, 2017
Last Verified: March 2017

Keywords provided by Julio Ramirez, University of Louisville:
Osteomyelitis
IV Antibiotics
Oral Antibiotics

Additional relevant MeSH terms:
Osteomyelitis
Bone Diseases, Infectious
Infection
Bone Diseases
Musculoskeletal Diseases
Anti-Bacterial Agents
Amoxicillin
Moxifloxacin
Fluoroquinolones
Vancomycin
Clarithromycin
Doxycycline
Minocycline
Ciprofloxacin
Levofloxacin
Ofloxacin
Rifampin
Clindamycin
Clindamycin palmitate
Clindamycin phosphate
Isoniazid
Gentamicins
Linezolid
Cycloserine
Ceftriaxone
Meropenem
Tazobactam
Piperacillin
Pyrazinamide
Penicillins