ClinicalTrials.gg
Status unknownNCT00097734Updated Feb 14, 2006

Study to Evaluate the Duration of Treatment With Ertapenem in Acute Attacks of Sigmoid Diverticulitis

A Phase 4 interventional study of ertapenem in Diverticulitis, Colonic and Acute Disease, sponsored by Klinikum Hanover-Siloah Hospital. Status unknown at 1 site in Germany. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2006-02-14.

Sponsored by Klinikum Hanover-Siloah Hospital · Phase 4, Interventional, and Educational/counseling/training

The sponsor has not verified this record recently (last verified Feb 2006), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 4
Study type
Interventional
Enrollment
540
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The purpose of this study is to compare the efficacy (by assessing the clinical success of treatment) of intravenous antibiotic therapy with ertapenem in patients with acute attacks of sigmoid diverticulitis for 4 vs. 7 days.

02

Conditions studied

  • Diverticulitis, Colonic
  • Acute Disease

Keywords

  • diverticulitis
  • Invanz
  • Ertapenem
  • acute attacks
  • sigmoid diverticulitis
  • Acute attacks of sigmoid diverticulitis
03

In context

Diverticulitis, Colonic

27 studies on the registry are indexed under Diverticulitis, Colonic; 8 are open to participants now.

This study's enrollment of 540 is above the median of 142 across 10 interventional studies indexed under Diverticulitis, Colonic.

Browse Diverticulitis, Colonic studies →

Lead sponsor

This is the only study on the registry with Klinikum Hanover-Siloah Hospital as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • At least three of the following signs or symptoms of an acute attack of sigmoid diverticulitis must be present: *Fever (body temperature > 38°C, sublingual), *Abdominal tenderness, *Leukocytosis (leukocytes > 10,000/µl) and left shift of the differential blood count (>1% band forms), *Elevated CRP (> 20 mg/l)
  • Evidence of sigmoid diverticulitis by contrast enema
  • CT evidence of wall thickening in the sigmoid intestine
  • Decision in favor of conservative therapy on the basis of the case history and diagnosis

Exclusion criteria

Exclusion Criteria:

  • for the use of the study medication or other beta-lactam antibiotics, e.g. patients with advanced renal impairment or patients requiring hemodialysis
  • Antibiotic therapy in the two weeks prior to the start of the study
  • Patients with an advanced incurable disease
  • Patients with a hematologic/oncologic disease (leukemia, lymphoma)
  • Patients on
  • Complications of sigmoid diverticulitis leading to an immediate indication for surgery
  • Patients who have to beta-lactam antibiotics
  • Female patients who are pregnant or nursing or who could become pregnant during the study
  • Participation in another clinical study or use of another study drug within the four weeks prior to enrollment in the study or use of another drug during the study
  • Each patient can be enrolled only once in the study
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 4
Primary purpose
Educational/counseling/training
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
540 participants

Interventions

06

What researchers measure

Primary outcomes

  1. Clinical therapeutic success (full regression)

  2. Relapse rate

  3. Operation rate

Secondary outcomes

  1. Development of laboratory parameters

  2. Duration of hospitalization

  3. Duration of parenteral feeding

  4. Incidence of surgical intervention and repeat surgery

  5. Incidence and duration of intensive care

07

Study locations

1 of 1 sites recruiting
  • Klinikum Hannover- Krankenhaus Siloah
    Hannover, 30449, Germany
    Recruiting
    • Omar Huegel, Dr. · Contact0049-511-927-2331
    • Ferdinand Koeckerling, Prof. Dr. · Principal investigator
    • Omar Huegel, Dr. · Sub investigator
    • Pascal Geers, Dr. · Sub investigator
08

References and documents

Publications

  • Ambrosetti P, Robert J, Witzig JA, Mirescu D, de Gautard R, Borst F, Meyer P, Rohner A. Prognostic factors from computed tomography in acute left colonic diverticulitis. Br J Surg. 1992 Feb;79(2):117-9. doi: 10.1002/bjs.1800790208. PubMed 1555056 ↗
  • Auguste L, Borrero E, Wise L. Surgical management of perforated colonic diverticulitis. Arch Surg. 1985 Apr;120(4):450-2. doi: 10.1001/archsurg.1985.01390280044010. PubMed 3985790 ↗
  • Bakker FC, Hoitsma HF, Den Otter G. The Hartmann procedure. Br J Surg. 1982 Oct;69(10):580-2. doi: 10.1002/bjs.1800691007. PubMed 7127036 ↗
  • Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990 Feb;174(2):331-6. doi: 10.1148/radiology.174.2.2296641. PubMed 2296641 ↗
  • Bell GA, Panton ON. Hartmann resection for perforated sigmoid diverticulitis. A retrospective study of the Vancouver General Hospital experience. Dis Colon Rectum. 1984 Apr;27(4):253-6. PubMed 6714033 ↗
  • Berry AR, Turner WH, Mortensen NJ, Kettlewell MG. Emergency surgery for complicated diverticular disease. A five-year experience. Dis Colon Rectum. 1989 Oct;32(10):849-54. doi: 10.1007/BF02554554. PubMed 2791771 ↗
  • BOLES RS Jr, JORDAN SM. The clinical significance of diverticulosis. Gastroenterology. 1958 Dec;35(6):579-82. No abstract available. PubMed 13609810 ↗
  • Chappuis CW, Cohn I Jr. Acute colonic diverticulitis. Surg Clin North Am. 1988 Apr;68(2):301-13. doi: 10.1016/s0039-6109(16)44479-8. PubMed 3279548 ↗
  • Cheskin LJ, Bohlman M, Schuster MM. Diverticular disease in the elderly. Gastroenterol Clin North Am. 1990 Jun;19(2):391-403. PubMed 2194951 ↗
  • Cheskin LJ, Lamport RD. Diverticular disease. Epidemiology and pharmacological treatment. Drugs Aging. 1995 Jan;6(1):55-63. doi: 10.2165/00002512-199506010-00005. PubMed 7696779 ↗
  • Cho KC, Morehouse HT, Alterman DD, Thornhill BA. Sigmoid diverticulitis: diagnostic role of CT--comparison with barium enema studies. Radiology. 1990 Jul;176(1):111-5. doi: 10.1148/radiology.176.1.2191360. PubMed 2191360 ↗
  • Chodak GW, Rangel DM, Passaro E Jr. Colonic diverticulitis in patients under age 40: need for earlier diagnosis. Am J Surg. 1981 Jun;141(6):699-702. doi: 10.1016/0002-9610(81)90081-7. No abstract available. PubMed 7246860 ↗
  • Cunha BA. Ertapenem. A review of its microbiologic, pharmacokinetic and clinical aspects. Drugs Today (Barc). 2002 Mar;38(3):195-213. doi: 10.1358/dot.2002.38.3.820127. PubMed 12532175 ↗
  • Detry R, Jamez J, Kartheuser A, Zech F, Vanheuverzwijn R, Hoang P, Kestens PJ. Acute localized diverticulitis: optimum management requires accurate staging. Int J Colorectal Dis. 1992 Feb;7(1):38-42. doi: 10.1007/BF01647660. PubMed 1588224 ↗
  • Doringer E. Computerized tomography of colonic diverticulitis. Crit Rev Diagn Imaging. 1992;33(5):421-35. PubMed 1418606 ↗
  • Drusano GL, Warren JW, Saah AJ, Caplan ES, Tenney JH, Hansen S, Granados J, Standiford HC, Miller EH Jr. A prospective randomized controlled trial of cefoxitin versus clindamycin-aminoglycoside in mixed anaerobic-aerobic infections. Surg Gynecol Obstet. 1982 May;154(5):715-20. PubMed 7041297 ↗
  • Duma RJ, Kellum JM. Colonic diverticulitis: microbiologic, diagnostic, and therapeutic considerations. Curr Clin Top Infect Dis. 1991;11:218-47. No abstract available. PubMed 1867769 ↗
  • Eisenstat TE, Rubin RJ, Salvati EP. Surgical management of diverticulitis. The role of the Hartmann procedure. Dis Colon Rectum. 1983 Jul;26(7):429-32. doi: 10.1007/BF02556519. PubMed 6861572 ↗
  • Elsakr R, Johnson DA, Younes Z, Oldfield EC 3rd. Antimicrobial treatment of intra-abdominal infections. Dig Dis. 1998 Jan-Feb;16(1):47-60. doi: 10.1159/000016848. PubMed 9549036 ↗
  • Ertan A. Colonic diverticulitis. Recognizing and managing its presentations and complications. Postgrad Med. 1990 Sep 1;88(3):67-72; 77. doi: 10.1080/00325481.1990.11704725. PubMed 2169049 ↗
  • Eusebio EB, Eisenberg MM. Natural history of diverticular disease of the colon in young patients. Am J Surg. 1973 Mar;125(3):308-11. doi: 10.1016/0002-9610(73)90047-0. No abstract available. PubMed 4690116 ↗
  • Ferzoco LB, Raptopoulos V, Silen W. Acute diverticulitis. N Engl J Med. 1998 May 21;338(21):1521-6. doi: 10.1056/NEJM199805213382107. No abstract available. PubMed 9593792 ↗
  • Freischlag J, Bennion RS, Thompson JE Jr. Complications of diverticular disease of the colon in young people. Dis Colon Rectum. 1986 Oct;29(10):639-43. doi: 10.1007/BF02560326. PubMed 3757703 ↗
  • Barry AL, Fuchs PC, Brown SD. In vitro activity of the ketolide ABT-773. Antimicrob Agents Chemother. 2001 Oct;45(10):2922-4. doi: 10.1128/AAC.45.10.2922-2924.2001. PubMed 11557491 ↗
  • Goldstein EJ, Citron DM, Merriam CV, Warren Y, Tyrrell K. Comparative in vitro activities of GAR-936 against aerobic and anaerobic animal and human bite wound pathogens. Antimicrob Agents Chemother. 2000 Oct;44(10):2747-51. doi: 10.1128/AAC.44.10.2747-2751.2000. PubMed 10991855 ↗
  • Gottesman L, Zevon SJ, Brabbee GW, Dailey T, Wichern WA Jr. The use of water-soluble contrast enemas in the diagnosis of acute lower left quadrant peritonitis. Dis Colon Rectum. 1984 Feb;27(2):84-8. doi: 10.1007/BF02553980. PubMed 6697835 ↗
  • Hachigian MP, Honickman S, Eisenstat TE, Rubin RJ, Salvati EP. Computed tomography in the initial management of acute left-sided diverticulitis. Dis Colon Rectum. 1992 Dec;35(12):1123-9. doi: 10.1007/BF02251962. Erratum In: Dis Colon Rectum 1993 Feb;36(2):193. PubMed 1473412 ↗
  • Hackford AW, Schoetz DJ Jr, Coller JA, Veidenheimer MC. Surgical management of complicated diverticulitis. The Lahey Clinic experience, 1967 to 1982. Dis Colon Rectum. 1985 May;28(5):317-21. doi: 10.1007/BF02560431. PubMed 3996147 ↗
  • Haglund U, Hellberg R, Johnsen C, Hulten L. Complicated diverticular disease of the sigmoid colon. An analysis of short and long term outcome in 392 patients. Ann Chir Gynaecol. 1979;68(2):41-6. No abstract available. PubMed 507737 ↗
  • Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg. 1978;12:85-109. PubMed 735943 ↗
  • Hiltunen KM, Kolehmainen H, Vuorinen T, Matikainen M. Early water-soluble contrast enema in the diagnosis of acute colonic diverticulitis. Int J Colorectal Dis. 1991 Nov;6(4):190-2. doi: 10.1007/BF00341388. PubMed 1770284 ↗
  • HORNER JL. A study of diverticulitis of the colon in office practice. Gastroenterology. 1952 Jun;21(2):223-9. No abstract available. PubMed 14937207 ↗
  • Hulkko OA, Laitinen ST, Haukipuro KA, Stahlberg MJ, Juvonen TS, Kairaluoma MI. The Hartmann procedure for the treatment of colorectal emergencies. Acta Chir Scand. 1986 Aug-Sep;152:531-5. PubMed 3788398 ↗
  • Johnson CD, Baker ME, Rice RP, Silverman P, Thompson WM. Diagnosis of acute colonic diverticulitis: comparison of barium enema and CT. AJR Am J Roentgenol. 1987 Mar;148(3):541-6. doi: 10.2214/ajr.148.3.541. PubMed 3492883 ↗
  • Kellum JM, Sugerman HJ, Coppa GF, Way LR, Fine R, Herz B, Speck EL, Jackson D, Duma RJ. Randomized, prospective comparison of cefoxitin and gentamicin-clindamycin in the treatment of acute colonic diverticulitis. Clin Ther. 1992 May-Jun;14(3):376-84. PubMed 1638578 ↗
  • Kourtesis GJ, Williams RA, Wilson SE. Acute diverticulitis: safety and value of contrast studies in predicting need for operation. Aust N Z J Surg. 1988 Oct;58(10):801-4. doi: 10.1111/j.1445-2197.1988.tb00983.x. PubMed 3250415 ↗
  • Krukowski ZH, Matheson NA. Emergency surgery for diverticular disease complicated by generalized and faecal peritonitis: a review. Br J Surg. 1984 Dec;71(12):921-7. doi: 10.1002/bjs.1800711202. PubMed 6388723 ↗
  • Laitinen R, Tahtinen J, Lantto T, Vorne M. Tc-99m labeled leukocytes in imaging of patients with suspected acute abdominal inflammation. Clin Nucl Med. 1990 Sep;15(9):597-602. doi: 10.1097/00003072-199009000-00001. PubMed 2208880 ↗
  • Larson DM, Masters SS, Spiro HM. Medical and surgical therapy in diverticular disease: a comparative study. Gastroenterology. 1976 Nov;71(5):734-7. PubMed 964566 ↗
  • LEIGH JE, JUDD ES, WAUGH JM. Diverticulitis of the colon. Recurrence after apparently adequate segmental resection. Am J Surg. 1962 Jan;103:51-4. doi: 10.1016/0002-9610(62)90012-0. No abstract available. PubMed 14463838 ↗
  • Lindahl J, Ristkari SK, Vorne M, Mokka RE. 99m-technetium-HmPAO-labelled leucocytes in the diagnosis of acute colonic diverticulitis. Acta Chir Scand. 1989 Sep;155(9):479-82. PubMed 2596257 ↗
  • Ling L, Aberg T. Hartmann procedure. Acta Chir Scand. 1984;150(5):413-7. PubMed 6435365 ↗
  • Livermore DM, Carter MW, Bagel S, Wiedemann B, Baquero F, Loza E, Endtz HP, van Den Braak N, Fernandes CJ, Fernandes L, Frimodt-Moller N, Rasmussen LS, Giamarellou H, Giamarellos-Bourboulis E, Jarlier V, Nguyen J, Nord CE, Struelens MJ, Nonhoff C, Turnidge J, Bell J, Zbinden R, Pfister S, Mixson L, Shungu DL. In vitro activities of ertapenem (MK-0826) against recent clinical bacteria collected in Europe and Australia. Antimicrob Agents Chemother. 2001 Jun;45(6):1860-7. doi: 10.1128/AAC.45.6.1860-1867.2001. PubMed 11353638 ↗
  • Makela J, Vuolio S, Kiviniemi H, Laitinen S. Natural history of diverticular disease: when to operate? Dis Colon Rectum. 1998 Dec;41(12):1523-8. doi: 10.1007/BF02237300. PubMed 9860333 ↗
  • Mazuski JE, Sawyer RG, Nathens AB, DiPiro JT, Schein M, Kudsk KA, Yowler C; Therapeutic Agents Committee of the Surgical Infections Society. The Surgical Infection Society guidelines on antimicrobial therapy for intra-abdominal infections: evidence for the recommendations. Surg Infect (Larchmt). 2002 Fall;3(3):175-233. doi: 10.1089/109629602761624180. PubMed 12542923 ↗
  • McConnell EJ, Tessier DJ, Wolff BG. Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age. Dis Colon Rectum. 2003 Aug;46(8):1110-4. doi: 10.1007/s10350-004-7288-4. PubMed 12907908 ↗
  • McGOWAN FJ, WOLFF WI. Diverticulitis of the sigmoid colon. Gastroenterology. 1952 May;21(1):119-32. No abstract available. PubMed 14926820 ↗
  • Morris J, Stellato TA, Lieberman J, Haaga JR. The utility of computed tomography in colonic diverticulitis. Ann Surg. 1986 Aug;204(2):128-32. doi: 10.1097/00000658-198608000-00005. PubMed 3741003 ↗
  • Murray JJ, Schoetz DJ Jr, Coller JA, Roberts PL, Veidenheimer MC. Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum. 1991 Jul;34(7):527-31. doi: 10.1007/BF02049889. PubMed 2055137 ↗
  • Nagorney DM, Adson MA, Pemberton JH. Sigmoid diverticulitis with perforation and generalized peritonitis. Dis Colon Rectum. 1985 Feb;28(2):71-5. doi: 10.1007/BF02552645. PubMed 3971809 ↗
  • Nichols RL. Management of intra-abdominal sepsis. Am J Med. 1986 Jun 30;80(6B):204-9. doi: 10.1016/0002-9343(86)90502-4. PubMed 3524217 ↗
  • Odenholt I, Lowdin E, Cars O. In vitro pharmacodynamic studies of L-749,345 in comparison with imipenem and ceftriaxone against gram-positive and gram-negative bacteria. Antimicrob Agents Chemother. 1998 Sep;42(9):2365-70. doi: 10.1128/AAC.42.9.2365. PubMed 9736564 ↗
  • Painter NS. Diverticular disease of the colon. The first of the Western diseases shown to be due to a deficiency of dietary fibre. S Afr Med J. 1982 Jun 26;61(26):1016-20. PubMed 6283684 ↗
  • Papi C, Ciaco A, Koch M, Capurso L. Efficacy of rifaximin in the treatment of symptomatic diverticular disease of the colon. A multicentre double-blind placebo-controlled trial. Aliment Pharmacol Ther. 1995 Feb;9(1):33-9. doi: 10.1111/j.1365-2036.1995.tb00348.x. PubMed 7766741 ↗
  • Parks TG. Natural history of diverticular disease of the colon. A review of 521 cases. Br Med J. 1969 Dec 13;4(5684):639-42. doi: 10.1136/bmj.4.5684.639. PubMed 5359917 ↗
  • Parks TG, Connell AM. The outcome in 455 patients admitted for treatment of diverticular disease of the colon. Br J Surg. 1970 Oct;57(10):775-8. doi: 10.1002/bjs.1800571021. No abstract available. PubMed 5476757 ↗
  • Perkins JD, Shield CF 3rd, Chang FC, Farha GJ. Acute diverticulitis. Comparison of treatment in immunocompromised and nonimmunocompromised patients. Am J Surg. 1984 Dec;148(6):745-8. doi: 10.1016/0002-9610(84)90429-x. PubMed 6507744 ↗
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  • Porta E, Germano A, Ferrieri A, Koch M. The natural history of diverticular disease of the colon: a role for antibiotics in preventing complications? A retrospective study. Riv Eur Sci Med Farmacol. 1994 Jan-Apr;16(1-2):33-9. PubMed 7761680 ↗
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  • Roberts P, Abel M, Rosen L, Cirocco W, Fleshman J, Leff E, Levien D, Pritchard T, Wexner S, Hicks T, et al. Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 1995 Feb;38(2):125-32. doi: 10.1007/BF02052438. PubMed 7851165 ↗
  • Sarin S, Boulos PB. Evaluation of current surgical management of acute inflammatory diverticular disease. Ann R Coll Surg Engl. 1991 Sep;73(5):278-82. PubMed 1929127 ↗
  • Shah PM, Isaacs RD. Ertapenem, the first of a new group of carbapenems. J Antimicrob Chemother. 2003 Oct;52(4):538-42. doi: 10.1093/jac/dkg404. Epub 2003 Sep 1. No abstract available. PubMed 12951340 ↗
  • Smith TR, Cho KC, Morehouse HT, Kratka PS. Comparison of computed tomography and contrast enema evaluation of diverticulitis. Dis Colon Rectum. 1990 Jan;33(1):1-6. doi: 10.1007/BF02053191. PubMed 2295271 ↗
  • Solomkin JS, Yellin AE, Rotstein OD, Christou NV, Dellinger EP, Tellado JM, Malafaia O, Fernandez A, Choe KA, Carides A, Satishchandran V, Teppler H; Protocol 017 Study Group. Ertapenem versus piperacillin/tazobactam in the treatment of complicated intraabdominal infections: results of a double-blind, randomized comparative phase III trial. Ann Surg. 2003 Feb;237(2):235-45. doi: 10.1097/01.SLA.0000048551.32606.73. PubMed 12560782 ↗
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  • Wexner SD, Dailey TH. The initial management of left lower quadrant peritonitis. Dis Colon Rectum. 1986 Oct;29(10):635-8. doi: 10.1007/BF02560324. PubMed 3757702 ↗
  • Woods RJ, Lavery IC, Fazio VW, Jagelman DG, Weakley FL. Internal fistulas in diverticular disease. Dis Colon Rectum. 1988 Aug;31(8):591-6. doi: 10.1007/BF02556792. PubMed 3402284 ↗
  • WELCH CE, ALLEN AW, DONALDSON GA. An appraisal of resection of the colon for diverticulitis of the sigmoid. Ann Surg. 1953 Sep;138(3):332-43. doi: 10.1097/00000658-195313830-00005. No abstract available. PubMed 13080959 ↗
09

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Jul 2004 and a completion of Jun 2007. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 29, 2004
First posted
Nov 30, 2004
Start
Jul 2004
Completion
Jun 2007
Last update
Feb 14, 2006
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
No changes since tracking began. The registry record was last updated on Feb 14, 2006, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00097734
Lead sponsor
Klinikum Hanover-Siloah Hospital
First posted
Nov 30, 2004
Start date
Jul 2004
Completion
Jun 2007
Last update
Feb 14, 2006

Study contacts

Ferdinand Koeckerling, Prof. Dr.
Contact
ferdinand.koeckerling.siloah@klinikum-hannover.de
0049-511-927-2331
Omar Huegel, Dr.
Contact
Dr.O.Huegel@arcor.de
0049-511-927-2331
Ferdinand Koeckerling, Prof. Dr.
study chair · Klinikum Hanover-Siloah hospital and Nordstadt hospital- Surgical Department
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Ertapenem

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