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CompletedNCT00336505Updated Feb 26, 2010Results posted

Study Comparing the Safety and Efficacy of Cethromycin to Clarithromycin for the Treatment of Community-Acquired Pneumonia (CAP)

A Phase 3 interventional study of Cethromycin and Clarithromycin in Pneumonia, sponsored by Advanced Life Sciences, Inc.. Completed at 3 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2010-02-26.

Sponsored by Advanced Life Sciences, Inc. · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
584
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to compare the efficacy of cethromycin to clarithromycin for the treatment of mild to moderate community-acquired pneumonia (CAP).

Read the detailed description

Lower respiratory tract infections remain one of the leading causes of death worldwide. Increasing rates of antibiotic resistance and newer, more pervasive pneumonia-causative pathogens contribute to this statistic. Currently available macrolide antibiotics for the treatment of community-acquired pneumonia are slowly losing effectiveness, resulting in the need to develop newer drugs to fight resistant infections. In this study, we compare the safety and efficacy of a common macrolide, clarithromycin, to a new ketolide, cethromycin.

02

Conditions studied

  • Pneumonia

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Keywords

  • Pneumonia
  • Respiratory
  • Infection
  • Infectious
  • Advanced
  • Life
  • Sciences
  • Lung
  • Pulmonary
  • Cethromycin
  • Restanza
  • Clarithromycin
  • Biaxin
03

In context

Pneumonia

2,044 studies on the registry are indexed under Pneumonia; 283 are open to participants now.

This study's enrollment of 584 is above the median of 106 across 1,247 interventional studies indexed under Pneumonia.

Browse Pneumonia studies →

Lead sponsor

Advanced Life Sciences, Inc. is the lead sponsor of 3 studies on the registry; none are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Ambulatory male or female, 18 years of age or older
  • If female, non-lactating and at no risk or pregnancy (post-menopausal or must use adequate birth control)
  • Positive Chest X-ray consistent with diagnosis of bacterial pneumonia
  • Must be a suitable candidate for oral antibiotic therapy and must be able to swallow capsules intact
  • Recent history of respiratory illness consistent with the clinical signs and symptoms of bacterial CAP
  • Must be able to produce sputum

Exclusion criteria

Exclusion Criteria:

  • Prior hospitalization within previous 4 weeks
  • Residence at a chronic care facility
  • Active tuberculosis (or other mycobacterial infection, empyema, lung abscess, pulmonary embolism, pulmonary edema, cystic fibrosis, tumor (primary or metastatic) involving the lung, bronchial obstruction, a history of post-obstructive pneumonia (chronic obstructive pulmonary disease [COPD] is not exclusionary), known or suspected Pneumocystis carinii pneumonia
  • Treatment with long-acting antimicrobial agents within the last 4 weeks, treatment with ceftriaxone, azithromycin or dirithromycin antibiotic within the last 7 days, or subjects who have received more than 24 hours of treatment with other antibiotics within 7 days prior to study drug administration
  • Any infection which requires the use of a concomitant antimicrobial agent
  • History of hypersensitivity or allergic reactions to macrolide, ketolide, quinolone, azalide or streptogramin antimicrobials
  • Treatment with another investigational drug within the last 4 weeks
  • Females who are pregnant or lactating
  • Subjects with known significant renal or hepatic impairment or disease
  • Subjects with a history of impaired renal function
  • Evidence of uncontrolled clinically significant cardiovascular, pulmonary, metabolic, gastrointestinal, neurological or endocrine disease, malignancy, or other abnormality (other than the disease being studied)
  • Subjects who would require parenteral antimicrobial therapy for the treatment of pneumonia
  • Any underlying disease or condition that would interfere with the completion of the study procedures and evaluations or absorption of the study drug
  • Currently receiving or are likely to require any of the following medications during the period between 2 weeks prior to Evaluation 1 and within 24 hours after the last dose of study drug: astemizol (Hismanal®) or pimozide (Orap®)
  • Currently receiving or are likely to require any of the following during the period from Evaluation 1 and within 24 hours after the last dose of study drug: theophylline or theophylline analogues (unless adequately monitored), carbamazepine, dexamethasone, phenobarbital, phenytoin, St. John's Wort, lamotrigine, troglitazone, warfarin and digitalis glycoside. Other barbiturates may be used with careful monitoring
  • Subjects who are currently receiving or who are likely to require any of the following medications during the period between Evaluation 1 and 4: other systemic antibiotic therapy, rifampin or rifabutin
  • Immunocompromised subjects, subjects receiving immunosuppressive agents, subjects with known human immunodeficiency virus (HIV) infections and history of acquired immune deficiency syndrome (AIDS) defining conditions or CD4+ T-lymphocyte count \<200.
  • Subject with known or suspected central nervous system (CNS) disorder that predisposes them to seizures/lower seizure threshold (e.g., severe cerebral arteriosclerosis, epilepsy)
  • Previous treatment with cethromycin
  • Subjects with signs of septic shock (e.g., mental confusion, severe hypoxemia, severe hypotension, any other condition requiring intensive care unit [ICU] admission)
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
584 participants (actual)

Study arms

  • Active comparator
    Clarithromycin

    Drug: Clarithromycin

  • Experimental
    Cethromycin

    Drug: Cethromycin

Interventions

  • DrugCethromycin

    Cethromycin 300 mg once per day (QD) for 7 days, administered orally

    Also known as: Restanza, ABT-773

  • DrugClarithromycin

    Clarithromycin 250 mg twice per day (BID) for 7 days, administered orally

    Also known as: Biaxin, Klacid, Klaracid

06

What researchers measure

Primary outcomes

  1. Clinical Cures in the Intent to Treat Population

    Investigators evaluated subjects for a clinical response of cure, failure, or indeterminate. Cure: Improvement or return to preinfection state or lack of progression of all pulmonary infiltrates, and resolution of all signs/symptoms present at enrollment. Failure: Persistence or worsening of signs/symptoms, the need for additional antibiotic, new pulmonary infection, progression of the chest radiograph, or death due to pneumonia. Indeterminate: Evaluation was not possible (lost to follow up, adverse event, major protocol violation). Indeterminates default to failure for analysis.

    Time frame: Test of Cure Visit, defined as 14-22 days after the first dose of study drug.

  2. Clinical Cures in the Per Protocol Clinically Evaluable Population

    Investigators evaluated subjects for a clinical response of cure, failure, or indeterminate. Cure: Improvement or return to preinfection state or lack of progression of all pulmonary infiltrates, and resolution of all signs/symptoms present at enrollment. Failure: Persistence or worsening of signs/symptoms, the need for additional antibiotic, new pulmonary infection, progression of the chest radiograph, or death due to pneumonia. Indeterminate: Evaluation was not possible (lost to follow up, adverse event, major protocol violation). Indeterminates default to failure for analysis.

    Time frame: Test of Cure Visit, defined as 14-22 days after the first dose of study drug

Secondary outcomes

  1. Bacteriologic Cures in the Intent to Treat Population

    All bacteriologically evaluable subjects (ie., the subject had at least one, protocol-defined evaluable pathogen) who demonstrated eradication of all evaluable pathogens (S. pneumoniae, S. aureus, H. influenzae, M. catarrhalis, M. pneumoniae, C. pneumoniae, L. pneumophila).

    Time frame: Test of Cure Visit, defined as 14-22 days after the first dose of study drug.

  2. Bacteriologic Cures in the Per Protocol Clinically Evaluable Population

    All bacteriologically evaluable subjects (ie., the subject had at least one, protocol-defined evaluable pathogen) who demonstrated eradication of all evaluable pathogens (S. pneumoniae, S. aureus, H. influenzae, M. catarrhalis, M. pneumoniae, C. pneumoniae, L. pneumophila).

    Time frame: Test of Cure Visit, defined as 14-22 days after the first dose of study drug.

07

Results

Posted Feb 26, 2010

Participant flow

Subjects were recruited globally from January 2006 through October 2007.

Participant flow — Overall Study
MilestoneCethromycinClarithromycin
Started291291
Completed254264
Not completed3727
Withdrew: Adverse event109
Withdrew: Lack of efficacy84
Withdrew: Lost to follow-up74
Withdrew: Withdrawal by subject53
Withdrew: Other77

Outcome measures

PrimaryClinical Cures in the Intent to Treat Population

Investigators evaluated subjects for a clinical response of cure, failure, or indeterminate. Cure: Improvement or return to preinfection state or lack of progression of all pulmonary infiltrates, and resolution of all signs/symptoms present at enrollment. Failure: Persistence or worsening of signs/symptoms, the need for additional antibiotic, new pulmonary infection, progression of the chest radiograph, or death due to pneumonia. Indeterminate: Evaluation was not possible (lost to follow up, adverse event, major protocol violation). Indeterminates default to failure for analysis.

Time frame:
Test of Cure Visit, defined as 14-22 days after the first dose of study drug.
Reported as:
Number · Participants
Clinical Cures in the Intent to Treat Population
ParticipantsCethromycinClarithromycin
Clinical Cures217206
Clinical Failures1413
Indeterminates3035
Statistical analysis
  • Cethromycin vs Clarithromycin · Fisher Exact · p = 0.5667 · Mean difference (net): 2.0 · 95% CI -4.8 to 8.9
SecondaryBacteriologic Cures in the Intent to Treat Population

All bacteriologically evaluable subjects (ie., the subject had at least one, protocol-defined evaluable pathogen) who demonstrated eradication of all evaluable pathogens (S. pneumoniae, S. aureus, H. influenzae, M. catarrhalis, M. pneumoniae, C. pneumoniae, L. pneumophila).

Time frame:
Test of Cure Visit, defined as 14-22 days after the first dose of study drug.
Reported as:
Number · Participants
Bacteriologic Cures in the Intent to Treat Population
ParticipantsCethromycinClarithromycin
Bacteriologic Cures7373
PrimaryClinical Cures in the Per Protocol Clinically Evaluable Population

Investigators evaluated subjects for a clinical response of cure, failure, or indeterminate. Cure: Improvement or return to preinfection state or lack of progression of all pulmonary infiltrates, and resolution of all signs/symptoms present at enrollment. Failure: Persistence or worsening of signs/symptoms, the need for additional antibiotic, new pulmonary infection, progression of the chest radiograph, or death due to pneumonia. Indeterminate: Evaluation was not possible (lost to follow up, adverse event, major protocol violation). Indeterminates default to failure for analysis.

Time frame:
Test of Cure Visit, defined as 14-22 days after the first dose of study drug
Reported as:
Number · Participants
Clinical Cures in the Per Protocol Clinically Evaluable Population
ParticipantsCethromycinClarithromycin
Clinical Cures205195
Clinical Failures1313
Statistical analysis
  • Cethromycin vs Clarithromycin · Fisher Exact · p = >0.9999 · Mean difference (net): 0.3 · 95% CI -4.5 to 5.1
SecondaryBacteriologic Cures in the Per Protocol Clinically Evaluable Population

All bacteriologically evaluable subjects (ie., the subject had at least one, protocol-defined evaluable pathogen) who demonstrated eradication of all evaluable pathogens (S. pneumoniae, S. aureus, H. influenzae, M. catarrhalis, M. pneumoniae, C. pneumoniae, L. pneumophila).

Time frame:
Test of Cure Visit, defined as 14-22 days after the first dose of study drug.
Reported as:
Number · Participants
Bacteriologic Cures in the Per Protocol Clinically Evaluable Population
ParticipantsCethromycinClarithromycin
Bacteriologic Cures7167

Adverse events

Collected over Reported adverse events were recorded for 30 days after the last dose of study drug for individual subjects.. Non-serious events are listed at a 2% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Cethromycin—13/288 (4.5%)55/288 (19.1%)
Clarithromycin—9/291 (3.1%)37/291 (12.7%)
Most frequent serious events
Showing 10 of 18
Most frequent serious events
EventCethromycinClarithromycin
Acute myocardial infarctionCardiac disorders4/2881/291
PneumoniaInfections and infestations4/2882/291
Atrial FibrillationCardiac disorders1/2880/291
Cardiac failure congestiveCardiac disorders1/2880/291
Pericardial effusionCardiac disorders1/2880/291
EmpyemaInfections and infestations1/2880/291
Ankle fractureInjury, poisoning and procedural complications1/2880/291
Lung adenocarcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/2881/291
Metastatic neoplasmNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/2880/291
Renal failure acuteRenal and urinary disorders1/2880/291
Most frequent other events
Most frequent other events
EventCethromycinClarithromycin
DysgeusiaNervous system disorders22/2886/291
DiarrheaGastrointestinal disorders13/28812/291
NauseaGastrointestinal disorders13/2884/291
HeadacheNervous system disorders7/2888/291
Urinary tract infectionInfections and infestations0/2887/291

Baseline characteristics

Age Continuous
Age Continuous(years)CethromycinClarithromycinTotal
Mean48.6 ± 14.550.3 ± 16.349.5 ± 15.4
Sex: Female, Male
Sex: Female, Male(Participants)CethromycinClarithromycinTotal
Female140143283
Male151148299
08

Study locations

3 sites
  • CANADA - Advanced Life Sciences
    Woodridge, Illinois 60517, United States
  • SOUTH AFRICA - Advanced Life Sciences
    Woodridge, Illinois 60517, United States
  • USA - Advanced Life Sciences
    Woodridge, Illinois 60517, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 26, 2010, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00336505
Lead sponsor
Advanced Life Sciences, Inc.
First posted
Jun 13, 2006
Start date
Dec 2005
Primary completion
Oct 2007
Completion
Oct 2007
Results posted
Feb 26, 2010
Last update
Feb 26, 2010

Study contacts

David A. Eiznhamer, PhD
study director · Advanced Life Sciences

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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