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TerminatedNCT04222257SATIEUpdated Sep 28, 2023

Short-course Antibiotic Treatment in Gram-positive Cocci Infective Endocarditis

A Phase 4 interventional study of Antibiotics and Antibiotics in Endocarditis, Bacterial, sponsored by Carmen Olmos Blanco. Terminated at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-09-28.

Sponsored by Carmen Olmos Blanco · Phase 4, Interventional, and Treatment

Why this study was terminated
Inability to reach the estimated sample size
Phase
Phase 4
Study type
Interventional
Enrollment
20
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Background: it is well known that most serious complications of infective endocarditis (IE) appear in the so-called "critical phase" of the disease, which are the first days after diagnosis. Subsequently, the vast majority of patients who overcome this acute phase has a favourable evolution, and usually stay in the hospital for a long time only to complete antibiotic therapy.

In stable patients with adequate response to antibiotic treatment, without signs of persistent infection or metastatic foci such as spondylodiscitis, it is likely that a shorter antibiotic regimen would be an efficient and safe alternative, as has already been confirmed in patients with IE on tricuspid valves caused by a microorganism considered virulent such as S. aureus. This attractive alternative would improve patients' quality of life, save costs, and decrease the risk of complications related to the adverse effects of prolonged antibiotic treatment.

Objectives: to compare the incidence of the composite endpoint of all-cause mortality, unplanned cardiac surgery, symptomatic embolisms and relapses within 6 months after the inclusion between patients with IE caused by gram-positive cocci receiving a short-course of 2 weeks of antibiotic therapy and those patients receiving conventional antibiotic therapy (4-6 weeks).

Methodology: multicenter, prospective, randomized, controlled open-label, phase IV clinical trial. Sample: patients with IE caused by gram-positive cocci, having received at least 10 days of conventional antibiotic treatment, and at least 7 days after surgery when indicated, without clinical, analytical, microbiological or echocardiographic signs of persistent infection. Estimated sample size: 298 patients. Intervention: Control group: standard antibiotic therapy, according to ESC guidelines recommendations, for 4 to 6 weeks. Experimental group: short-course antibiotic therapy for 2 weeks. The prevalence of previously known risk factors for adverse events will be compared between the two groups to confirm that randomization have worked properly. The incidence of the composite endpoint of all-cause mortality, unplanned cardiac surgery, symptomatic embolisms and relapses within 6 months after the inclusion in the study will be prospectively registered and compared.

02

Conditions studied

  • Endocarditis, Bacterial

Keywords

  • Infective endocarditis
  • short-course
  • antibiotic therapy
03

In context

Endocarditis, Bacterial

22 studies on the registry are indexed under Endocarditis, Bacterial; 9 are open to participants now.

This study's enrollment of 20 is below the median of 38 across 11 interventional studies indexed under Endocarditis, Bacterial.

Browse Endocarditis, Bacterial studies →

Lead sponsor

This is the only study on the registry with Carmen Olmos Blanco as lead sponsor.

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

  • Definite IE, according to modified ESC 2015 criteria, caused by gram-positive cocci (staphylococci, streptococci and enterococci), including native, prosthetic valve IE and cardiac device-related IE.
  • 18 years old or older.
  • Patients treated for at least 10 days of appropriate parenteral antibiotic therapy overall (according to guidelines and microbiology sensitivity testing), and at least 7 days of parenteral antibiotic therapy after valve surgery when indicated.
  • Absence of fever, microbiological or analytical findings suggesting persistent infection at randomization.
  • Absence of locally uncontrolled infection signs (abscess, pseudoaneurysm, fistula, enlarging vegetation) at randomization, confirmed by recent transesophageal echocardiography (performed within 48 h of randomization).
  • Women of who will agree to the use of effective methods while on antibiotic treatment.

Exclusion criteria

Exclusion Criteria:

  • Patients who have received appropriate parenteral antibiotic therapy for infective endocarditis for more than 12 days.
  • Patients not suitable to be discharged after 10 days of conventional treatment, due to clinical reasons (sequels of stroke that prevent discharge, progressive renal failure, hepatic failure).
  • Patients receiving chemotherapy or therapy.
  • Pregnant or breastfeeding women.
  • Need of prolonged antibiotic therapy due to spondylodiscitis or other septic complication.
  • Absence of patient's ability or commitment to continue follow-up after being discharged from hospital.
  • Inability to give to participation.
  • Cognitive impairment or lack of language skills needed to complete the questionnaires.
  • Patients who meet urgent cardiac surgery ESC criteria but are considered inoperable due to high surgical risk.
Terms in these criteria, in plain language(4)

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

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.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
20 participants (actual)

Study arms

  • Experimental
    Short course

    Patients allocated to this group will receive a short course of antibiotic therapy for 2 weeks.

    Drug: Antibiotics

  • Active comparator
    Standard course

    Those patients allocated to continue with standard parenteral treatment will maintain the same antibiotic treatment for 4 to 6 weeks.

    Drug: Antibiotics

Interventions

  • DrugAntibiotics

    Patients allocated to this group will receive a short course of antibiotic therapy for 2 weeks.

  • DrugAntibiotics

    Patients allocated to continue with standard parenteral treatment will maintain the same antibiotic treatment for 4 to 6 weeks.

06

What researchers measure

Primary outcomes

  1. Composite endopoint

    To compare the incidence of the composite endpoint that includes all-cause mortality, unplanned cardiac surgery, symptomatic embolisms and relapses within 6 months after the inclusion, between patients with IE caused by gram-positive cocci receiving a short course of 2 weeks of antibiotic therapy and those patients receiving conventional antibiotic therapy for 4-6 weeks.

    Time frame: 6 months

Secondary outcomes

  1. Perceived quality of life: SF-12

    Determination of quality of life (SF-12)

    Time frame: 4 weeks

  2. Functional performance

    Determination of functional performance according to the short performance physical battery test (SPPB)

    Time frame: 4 weeks

  3. Clinical complications

    Clinical complications related to hospital stay (nosocomial infections, intravascular catheter-related infections)

    Time frame: 6 months

  4. Total hospital length of stay

    Total hospital length of stay in the next 6 months after the inclusion in the study

    Time frame: 6 months

07

Study locations

1 site
  • Cardiovascular Institute. Hospital Clínico San Carlos
    Madrid, 28040, Spain
08

References and documents

Publications

  • Olmos C, Vilacosta I, Lopez J, Saez C, Anguita M, Garcia-Granja PE, Sarria C, Silva J, Alvarez-Alvarez B, Martinez-Monzonis MA, Castillo JC, Seijas J, Lopez-Picado A, Peral V, Maroto L, San Roman JA. Short-course antibiotic regimen compared to conventional antibiotic treatment for gram-positive cocci infective endocarditis: randomized clinical trial (SATIE). BMC Infect Dis. 2020 Jun 16;20(1):417. doi: 10.1186/s12879-020-05132-1. PubMed 32546269 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jan 2021 to primary completion in Mar 2023, 26 months.

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

Registered
Dec 19, 2019
First posted
Jan 9, 2020
StartActual
Jan 26, 2021
Primary completionActual
Mar 31, 2023
CompletionActual
Apr 1, 2023
Last update
Sep 28, 2023
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 Sep 28, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04222257
Lead sponsor
Carmen Olmos Blanco
Responsible party
Carmen Olmos Blanco (Principal investigator, Hospital San Carlos, Madrid) — Sponsor-investigator
First posted
Jan 9, 2020
Start date
Jan 26, 2021
Primary completion
Mar 31, 2023
Completion
Apr 1, 2023
Last update
Sep 28, 2023

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Sep 2023. You cannot join it, but the record below documents what was studied.

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