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Status unknownNCT03269604Updated Jan 24, 2018

Effectiveness of Three Times of Starting Antibiotic Prophylaxis in Patients With Asymptomatic Bacteriuria.

An interventional study of Prophylactic antibiotic during five days previous to the procedure and Prophylactic antibiotic during three days previous to the procedure in Asymptomatic Bacteriuria and Antibiotic Prophylaxis, sponsored by Jorge Andres Ramos Castaneda. Status unknown at 1 site in Colombia. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-01-24.

Sponsored by Jorge Andres Ramos Castaneda · Not applicable, Interventional, and Prevention

The sponsor has not verified this record recently (last verified Jan 2018), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
456
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Asymptomatic bacteriuria (AB) is the isolation of a bacterium in a sample of urine appropriately collected from a person who does not have signs or symptoms of urinary infection. It is common in diabetic women, in pregnant women, in men over 60 years and in patients with spinal cord injury.

There is clinical evidence that AB should be treated in patients who will be operated on with urologic surgery because of the risk of presenting infectious complications; however, the timing of initiating antibiotic therapy has not been established, even in some studies the prophylaxis has been considered from one to seven days prior to the procedure, without determining the differences in the outcome for each one of the interventions and causing an undue and risky use of antibiotics.

A randomized, parallel-design, single-masked clinical trial will be performed to compare and analysis the bloodstream infections, surgical site infections, readmissions and hospital stay in three intervention groups, 1) those receiving antibiotics during the previous 5 days to the procedure; 2) 3 days prior to the procedure; and 3) those who receive only a single dose of antibiotic on the day of the procedure.

The main expected result is to identify the timing of initiation of antibiotic prophylaxis in urological procedures in patients with asymptomatic bacteriuria, with the purpose of diminishing the bloodstream and of the surgical site infections. If it is scientifically demonstrated that those patients who receive a single dose of antibiotic on the same day of the procedure, have the same safety and effectiveness compared to the other two groups, would reduce hospital stay, surgical waiting time and indiscriminate use of antibiotics that generate multidrug-resistant microorganisms, thus generating an impact on Public Health and on the quality of care.

02

Conditions studied

  • Asymptomatic Bacteriuria
  • Antibiotic Prophylaxis

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Keywords

  • Urological Surgery
  • Bacterial resistance
03

Who can participate

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

Inclusion criteria

  • Age ≥ 18 years
  • Patients with asymptomatic bacteriuria identified with a urine culture prior to the surgical procedure and with a microorganism that meets the following criteria: 1) gram-negative bacteria in the enterobacterial family and non-fermenting bacilli; 2) Bacteria with resistance profile has a therapeutic option that reaches therapeutic concentration in urine.
  • Patients scheduled for urological procedures, such as: transurethral resection of the prostate, open prostatectomy, cystoscopy, extracorporeal lithotripsy and flexible ureterorenoscopy.
  • Informed consent

Exclusion criteria

Exclusion Criteria:

  • Patients with chronic renal failure; with immunosuppressive status secondary to glucocorticoid consumption, haematological or solid organ neoplasms undergoing chemotherapy or radiation therapy or neutropenia.
  • Patients with active infection or clinical criteria of urinary infection.
  • Patients who voluntarily do not want to participate in the study.
  • Patients who can not give informed consent under reasonable or vulnerable conditions.
  • Patients who present type I allergy to penicillin.
  • Patients who have scheduled surgeries combined with a discipline different to urology.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
456 participants (estimated)

Study arms

  • Active comparator
    Prophylactic antibiotic five days previous to the procedure

    Prophylactic antibiotic during five days previous to the procedure.

    Procedure: Prophylactic antibiotic during five days previous to the procedure

  • Active comparator
    Prophylactic antibiotic three days previous to the procedure

    Prophylactic antibiotic during three days previous to the procedure.

    Procedure: Prophylactic antibiotic during three days previous to the procedure

  • Experimental
    Only a single dose of Prophylactic antibiotic

    Only a single dose of Prophylactic antibiotic on the day of the procedure

    Procedure: Only a single dose of Prophylactic antibiotic

Interventions

  • ProcedureProphylactic antibiotic during five days previous to the procedure

    Prophylactic antibiotic during five days previous to the procedure.

  • ProcedureProphylactic antibiotic during three days previous to the procedure

    Prophylactic antibiotic during three days previous to the procedure.

  • ProcedureOnly a single dose of Prophylactic antibiotic

    This group will receive a single dose of antibiotic 90 ± 20 minutes prior to the start of the surgical procedure (incision)

05

What researchers measure

Primary outcomes

  1. Bloodstream infection

    An infectious process characterized by the presence of some bacteria in the bloodstream. The patient should have one or more positive blood cultures, where the cultured organism is not related to an infection elsewhere, and has signs of infection, such as fever, hypotension or tachycardia.

    Time frame: 30 days

Secondary outcomes

  1. Surgical Site Infection:

    It can occur up to 30 days (or a year when a prosthetic component is involved) of a surgical procedure in some part of the body where it was manipulated in surgery. The SSI is classified as superficial, deep or organ space, depending on the type of tissue involved.

    Time frame: 30 days

  2. Length of hospital stay

    Difference in days between the date of discharge and of the surgical procedure.

    Time frame: 30 days

  3. Re-entry to hospitalization

    Re hospitalization after the surgical procedure due to SSI or bloodstream.

    Time frame: 30 days

06

Study locations

1 of 1 sites recruiting
  • Universidad CES
    Medellín, Antioquia 00000, Colombia
    • Jorge A Ramos, Ph.D Stud · Contact · ramos.jorge@uces.edu.co · +57 (4) 4440555
    • Jorge A Ramos, Ph.D Stud · Principal investigator
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03269604
Lead sponsor
Jorge Andres Ramos Castaneda
Responsible party
Jorge Andres Ramos Castaneda (Ph. D. student in Public Health, CES University) — Sponsor-investigator
First posted
Sep 1, 2017
Start date
Jan 22, 2018
Primary completion
Oct 2018 (estimated)
Completion
Nov 2018 (estimated)
Last update
Jan 24, 2018

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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