ClinicalTrials.gg
CompletedNCT00182429Updated Aug 15, 2018

Efficacy of Metronidazole Versus Metronidazole and Rifampin in CDAD Treatment

A Phase 3 interventional study of Metronidazole and Rifampin in Clostridium Enterocolitis, Antibiotic-Associated Diarrhea and Pseudomembranous Colitis, sponsored by McMaster University. Completed at 4 sites in Canada. Open to participants aged 14 Years and older. Per ClinicalTrials.gov, last updated 2018-08-15.

Sponsored by McMaster University · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
14 Years and older
Sex
All
01

Study summary

What is the difference between the use of one drug (Oral Metronidazole) versus the use of this same drug combined with another drug (Rifampin) in treatment of bacteria and infection-associated diarrhea in patients? This infection is an important cause of morbidity and mortality in both the community and hospitals, and the leading cause of hospital and chronic facility-acquired diarrhea. Research is important for the treatment of this infection. Patient care with use of two medication treatment regimens will be studied.

Read the detailed description

Clostridium difficile infection contributes to both community and hospital acquired morbidity and mortality. Metronidazole alone is usually considered the drug of choice, however, frequent relapses occur at a rate of 10-40%. The purpose of this study is to address the use of a combined drug regimen treatment (Metronidazole and Rifampin) for the treatment of CDAD. These drugs used together have been successful. Objectives are to determine the time (days) to resolution of symptoms in each treatment arm; to measure clinical relapse rates; and to assess adverse reactions related to treatment.

02

Conditions studied

  • Clostridium Enterocolitis
  • Antibiotic-Associated Diarrhea
  • Pseudomembranous Colitis
  • Pseudomembranous Enterocolitis
  • Pseudomembranous Enteritis

Keywords

  • Antibiotic associated diarrhea
  • C. difficile
  • Metronidazole
  • Rifampin
03

In context

Enterocolitis, Pseudomembranous

43 studies on the registry are indexed under Enterocolitis, Pseudomembranous; 5 are open to participants now.

This study's enrollment of 100 is close to the median of 100 across 29 interventional studies indexed under Enterocolitis, Pseudomembranous.

Browse Enterocolitis, Pseudomembranous studies →

Lead sponsor

McMaster University is the lead sponsor of 741 studies on the registry; 127 are open to participants now.

Of its 7 completed or terminated interventional studies of FDA-regulated products, 3 (43%) have results posted.

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

04

Who can participate

Ages eligible
14 Years and older
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

  • Inpatients + outpatients diagnosed with CDAD based on SHEA definition [Laboratory confirmation for presence of C.difficile toxin using enzyme immunoassay and no other etiology for diarrhea + Presence of 1 or more of the following: diarrhea (6 watery stool over 36 hours or 3 unformed stools in 24 hours for at least 2days), pseudomembranes at endoscopy].

Exclusion criteria

Exclusion Criteria:

  • Age \< 14 yr
  • Known to metronidazole, rifampin
  • Receiving medication(s) with potential significant drug interaction with rifampin
  • Active liver disease as indicated by > 200 U/L
  • Adynamic ileus
  • Toxic megacolon
  • Pregnancy
Terms in these criteria, in plain language(2)

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.

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.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double
Enrollment
100 participants

Interventions

06

What researchers measure

Primary outcomes

  1. Resolution of symptoms in each treatment arm (in days) up to 40 days (measured using daily stool and symptom diary).

Secondary outcomes

  1. Clinical relapse rate in each group (time to relapse in days) up to 40 days after initial diagnosis (measured by repeating C. difficile toxin assay and analyzing daily stool and symptom diary).

  2. Adverse reactions related to treatment within 40 days (measured using daily symptom diary and interviewing patient).

  3. Occurrance of metronidazole resistance in the organism (C. difficile) in relapse cases.

07

Study locations

4 sites
  • Hamilton General Hospital
    Hamilton, Ontario L8L 2X2, Canada
  • McMaster University Medical Centre
    Hamilton, Ontario L8N 3Z5, Canada
  • St. Joseph's Healthcare
    Hamilton, Ontario L8N 4A6, Canada
  • Henderson General Hospital
    Hamilton, Ontario L8V 1C3, Canada
08

References and documents

Publications

  • Buggy BP, Fekety R, Silva J Jr. Therapy of relapsing Clostridium difficile-associated diarrhea and colitis with the combination of vancomycin and rifampin. J Clin Gastroenterol. 1987 Apr;9(2):155-9. doi: 10.1097/00004836-198704000-00009. PubMed 3571889 ↗
  • Wenisch C, Parschalk B, Hasenhundl M, Hirschl AM, Graninger W. Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile-associated diarrhea. Clin Infect Dis. 1996 May;22(5):813-8. doi: 10.1093/clinids/22.5.813. Erratum In: Clin Infect Dis 1996 Aug;23(2):423. PubMed 8722937 ↗
  • Young GP, Ward PB, Bayley N, Gordon D, Higgins G, Trapani JA, McDonald MI, Labrooy J, Hecker R. Antibiotic-associated colitis due to Clostridium difficile: double-blind comparison of vancomycin with bacitracin. Gastroenterology. 1985 Nov;89(5):1038-45. doi: 10.1016/0016-5085(85)90206-9. PubMed 4043661 ↗
  • Olson MM, Shanholtzer CJ, Lee JT Jr, Gerding DN. Ten years of prospective Clostridium difficile-associated disease surveillance and treatment at the Minneapolis VA Medical Center, 1982-1991. Infect Control Hosp Epidemiol. 1994 Jun;15(6):371-81. doi: 10.1086/646934. PubMed 7632199 ↗
  • Dudley MN, McLaughlin JC, Carrington G, Frick J, Nightingale CH, Quintiliani R. Oral bacitracin vs vancomycin therapy for Clostridium difficile-induced diarrhea. A randomized double-blind trial. Arch Intern Med. 1986 Jun;146(6):1101-4. PubMed 3521518 ↗
  • Teasley DG, Gerding DN, Olson MM, Peterson LR, Gebhard RL, Schwartz MJ, Lee JT Jr. Prospective randomised trial of metronidazole versus vancomycin for Clostridium-difficile-associated diarrhoea and colitis. Lancet. 1983 Nov 5;2(8358):1043-6. doi: 10.1016/s0140-6736(83)91036-x. PubMed 6138597 ↗
  • Barbut F, Decre D, Burghoffer B, Lesage D, Delisle F, Lalande V, Delmee M, Avesani V, Sano N, Coudert C, Petit JC. Antimicrobial susceptibilities and serogroups of clinical strains of Clostridium difficile isolated in France in 1991 and 1997. Antimicrob Agents Chemother. 1999 Nov;43(11):2607-11. doi: 10.1128/AAC.43.11.2607. PubMed 10543736 ↗
  • de Lalla F, Nicolin R, Rinaldi E, Scarpellini P, Rigoli R, Manfrin V, Tramarin A. Prospective study of oral teicoplanin versus oral vancomycin for therapy of pseudomembranous colitis and Clostridium difficile-associated diarrhea. Antimicrob Agents Chemother. 1992 Oct;36(10):2192-6. doi: 10.1128/AAC.36.10.2192. PubMed 1444298 ↗
09

Timeline

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

The record gives a start of Feb 2004, a primary completion of Apr 2005 and a completion of Dec 2005. 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
Sep 13, 2005
First posted
Sep 16, 2005
Start
Feb 2004
Primary completionActual
Apr 30, 2005
CompletionActual
Dec 31, 2005
Last update
Aug 15, 2018
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
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.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 15, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00182429
Collaborators
The Physicians' Services Incorporated Foundation
First posted
Sep 16, 2005
Start date
Feb 2004
Primary completion
Apr 30, 2005
Completion
Dec 31, 2005
Last update
Aug 15, 2018

Study contacts

Christine H Lee, MD
study director · McMaster University
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Metronidazole · Rifampin

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