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CompletedNCT01876628C4CUpdated Aug 17, 2022

Adjunctive Clindamycin for Cellulitis: C4C Trial.

A Phase 4 interventional study of Flucloxacillin and Clindamycin in Cellulitis, sponsored by University Hospitals Bristol and Weston NHS Foundation Trust. Completed at 1 site in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-08-17.

Sponsored by University Hospitals Bristol and Weston NHS Foundation Trust · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
410
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The aim of this study is to see whether the addition of Clindamycin, a protein inhibiting antibiotic, to the standard antibiotic treatment of limb cellulitis, with Flucloxacillin, results in less tissue damage and a more rapid resolution of both systemic and local features, in a cost-effective manner. This study is a randomised controlled trial comparing Clindamycin with placebo.

Read the detailed description

Criteria to be used to assess tissue damage and clinical response:

  1. Fever, tachycardia, neutrophil count, urea and other laboratory parameters at five and ten days post first dose of clindamycin
  2. Limb swelling (by the measurement of limb circumference), skin surface temperature and tissue damage (by the proportion of the limb affected)
  3. Document the duration between initial systemic features and the development of local signs
  4. Examine the effect of the duration between systemic and local features and first dose of flucloxacillin on the subsequent duration and severity of cellulitis
  5. Examine the effect of duration between the first dose of flucloxacillin and the first dose of clindamycin on the subsequent duration and severity of cellulitis
  6. Identify and quantify possible side effects of clindamycin
02

Conditions studied

  • Cellulitis

Keywords

  • Clindamycin
  • Cellulitis
  • Flucloxacillin
  • Group A streptococcus
  • Staphylococcus aureus
03

In context

Cellulitis

160 studies on the registry are indexed under Cellulitis; 14 are open to participants now.

This study's enrollment of 410 is above the median of 157 across 124 interventional studies indexed under Cellulitis.

Browse Cellulitis studies →

Lead sponsor

University Hospitals Bristol and Weston NHS Foundation Trust is the lead sponsor of 24 studies on the registry; 1 is 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

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

  • Male or female subjects aged 18 or over who have a diagnosis of cellulitis of a single, upper or lower, limb
  • Who are able to understand the study and give consent
  • Who are able to take oral medication

Exclusion criteria

Exclusion Criteria:

  • Patients with a confirmed history of penicillin, flucloxacillin or clindamycin allergy
  • Patients known to be colonised with Methicillin-resistant Staphylococcus aureus or Methicillin-resistant Staphylococcus aureus isolated from wound within the last year
  • Patients unable to take oral medication
  • Previous history of Clostridium difficile colitis
  • Clindamycin taken within the last 30 days
  • Clinically unstable
  • Unable to understand the study or give consent
  • Any doubt over the certainty of the diagnosis of cellulitis
  • Patients taking any drug that is incompatible with either flucloxacillin or clindamycin
  • Pre-existing diarrhoea
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
410 participants (actual)

Study arms

  • Placebo comparator
    Flucloxacillin and Placebo oral capsule

    Intravenous or oral Flucloxacillin with a Placebo oral capsule

    Drug: Flucloxacillin · Drug: Placebo oral capsule

  • Active comparator
    Flucloxacillin and Clindamycin

    Intravenous or oral Flucloxacillin with Clindamycin oral capsule

    Drug: Flucloxacillin · Drug: Clindamycin

Interventions

  • Intravenous or oral Flucloxacillin. Minimum dose 500mg four times each day. Target duration 5 days less pre-recruitment beta-lactam duration.

    Also known as: Floxapen, Fluclomix, Ladropen

  • Clindamycin dose 300mg four times each day for 2 days, within 48 hours of commencing flucloxacillin. Clindamycin is over-encapsulated and externally identical to placebo.

    Also known as: Dalacin C, Daclin, Cleocin

  • DrugPlacebo oral capsule

    Placebo is externally identical to the over-encapsulated clindamycin and is taken four times each day for 2 days

06

What researchers measure

Primary outcomes

  1. Improvement based on a composite of systemic and local features

    Temperature less than 37.5 degrees centigrade, reduction in limb swelling and reduction in skin temperature

    Time frame: Day 5

Secondary outcomes

  1. Decrease in pain

    Assessed using a visual analogue score

    Time frame: Day 10

  2. Quality of life

    Assessment based on a questionnaire plus return to work or normal activities and absence of increased side-effects.

    Time frame: Day 30

  3. Physiological recovery

    Resolution of systemic features, composite inflammatory markers and recovery of renal function.

    Time frame: Day 10

07

Study locations

1 site
  • University Hospitals Bristol NHS Foundation Trust
    Bristol, BS2 8HW, United Kingdom
08

References and documents

Publications

  • Brindle R, Williams OM, Davies P, Harris T, Jarman H, Hay AD, Featherstone P. Adjunctive clindamycin for cellulitis: a clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis. BMJ Open. 2017 Mar 17;7(3):e013260. doi: 10.1136/bmjopen-2016-013260. PubMed 28314743 ↗

Individual participant data

Plan to share: Yes

09

Timeline

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

The record gives a start of Oct 2013, a primary completion of Dec 2015 and a completion of Mar 2016. 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
Jun 10, 2013
First posted
Jun 12, 2013
Start
Oct 2013
Primary completionActual
Dec 2015
CompletionActual
Mar 2016
Last update
Aug 17, 2022
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 17, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01876628
Lead sponsor
University Hospitals Bristol and Weston NHS Foundation Trust
Collaborators
University of Bristol, Public Health England
Responsible party
Sponsor
First posted
Jun 12, 2013
Start date
Oct 2013
Primary completion
Dec 2015
Completion
Mar 2016
Last update
Aug 17, 2022

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2022. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Clindamycin

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