The Safety and Efficacy of an Antibiotic Sponge in Diabetic Patients With Moderately Infected Foot Ulcers
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|ClinicalTrials.gov Identifier: NCT00659646|
Recruitment Status : Completed
First Posted : April 16, 2008
Results First Posted : August 30, 2021
Last Update Posted : January 27, 2022
|Condition or disease||Intervention/treatment||Phase|
|Diabetic Foot Ulcer||Drug: gentamicin-collagen sponge and levofloxacin Drug: Levofloxacin only||Phase 2|
Infected skin ulcers with diabetes can be very debilitating because they are difficult to heal. Diabetic ulcers are responsible for frequent health care visits, and are a major predictor of amputation. Diabetic ulcers can be caused by a patient's inability to sense pain or warmth as well as peripheral vascular disease, which causes diminished blood flow to the foot. Early aggressive treatment is necessary to treat infection and ultimately prevent the need for amputation.
Gentamicin is an antibiotic that is effective in treating certain kinds of infection. Collagen is a protein that is found in all mammals. The gentamicin-collagen sponge is a thin flat sponge made out of collagen that comes from cow tendons and containing gentamicin. When applied to an open ulcer, the collagen breaks down and the gentamicin is released into the ulcer, but very little is absorbed into the blood stream. The high levels of gentamicin in the open infected ulcer may help treat the infection.
In this study, all subjects will be given the necessary supplies and taught how to take care their foot ulcer. All subjects will also receive oral an antibiotic (levofloxacin). Additionally, subjects who are randomly assigned to receive the gentamicin-collagen sponge will place a gentamicin-collagen sponge on their ulcer during daily wound care.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||56 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||A Randomized, Controlled, Open Label Study of the Safety and Efficacy of a Topical Gentamicin Collagen Sponge Combined With An Antibiotic Compared to Antibiotic Therapy Alone in Diabetic Patients With Moderately Infected Foot Ulcers|
|Study Start Date :||April 2008|
|Actual Primary Completion Date :||May 2009|
|Actual Study Completion Date :||February 2010|
Gentamicin sponge applied into wound plus levofloxacin, 750 mg by mouth (po) or intravenous (IV) every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing
Drug: gentamicin-collagen sponge and levofloxacin
Topical Gentamicin Collagen Sponge: 10 × 10 cm in size And 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours.
Other Name: Collatamp G
Active Comparator: B
Levofloxacin, 750 mg po or IV every 24 hours or, if ulcer culture results show resistance to levofloxacin, alternative antimicrobial therapy as determined by susceptibility testing
Drug: Levofloxacin only
levofloxacin, 750 mg tablet po every 24 hours or 750 mg IV administered by slow infusion over 90 minutes every 24 hours
Other Name: Tavanic, Levaquin
- Number of Participants With a Clinical Cure at Visit 3 (Day 7) [ Time Frame: Day 7 of treatment ]Number of participants with a clinical cure in each treatment group at Visit 3 (Day 7). Clinical Cure is defined as positive clinical response and with pathogen eradication.
- Number of Participants With a Positive Clinical Response at Each Time Point [ Time Frame: Day 3, 7, 10,14, 21, 28 and 42 ]Number of patients with positive clinical response, defined as those with a clinical outcome of "clinical cure" or "clinical improvement" in each treatment group at/by each time point
- Number of Participants With a Clinical Cure at Each Visit Except Visit 3 (Day 7) [ Time Frame: Day 3, 10, 14, 21, 28 & 42 ]clinical cure is defined as having a positive clinical response and with pathogen eradication
- Number of Participants With Pathogen Eradication by Visit [ Time Frame: Day 3, 7, 10, 14, 21 & 28 ]
- Change From Baseline in Total Wound Surface Area Measured in cm^2 [ Time Frame: Day 3, 7, 10, 14, 21, 28 & 42 ]Wound Surface Area was measured in cm² Actual Values Total wound surface area was compared across treatments using 2-sample t-tests. Wound tracings were obtained at study visits by trained study personnel who were blinded to the patient data and regimen. A centralized imaging facility provided both wound perimeter and area measurements.
- Time to Clinical Cure [ Time Frame: Days 1 through 49 ]clinical cure is defined as having a positive clinical response and with pathogen eradication
- Visual Analog Scale (VAS) for Pain Assessment [ Time Frame: Day 3, 7, 10, 14, 21, 28 & 42 ]Measured on a Visual Analog Pain Scale (VAS) with the lowest possible value of 0 and highest 100 (0 - 100) at each time point. A lower score is better which means the patient experience lower pain. The score is calculated using the number of hours * the VAS score. This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. For each measure outcome - the minimum score is "0" and the maximum score is 100* the number of hours in that period.
- Lipsky Wound Score [ Time Frame: Days 3, 7, 10, 14, 21, 28, 42 ]The Lipsky wound scoring scale consists of scoring categories for purulent drainage, non-purulent drainage, erythema, induration, tenderness, pain, local warmth and wound measurements. This wound scoring system allows us to take the size and depth of the wound into consideration as well as all signs and symptoms of inflammation and infection. A quantitative score that assess wounds both at baseline and during therapy to compare wound scores over time. The higher the score the worse the inflammation and/or infection is. The Lowest score possible is "3" and the highest score possible is "64".
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): NCT00659646
|United States, Florida|
|Karr Foot Kare PA|
|Lakeland, Florida, United States, 33813|
|Study Director:||David Prior||Innocoll|