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CompletedNCT04709172Updated Oct 6, 2021

Pilot Study of Cefditoren Pivoxil in COVID-19 Patients With Mild to Moderate Pneumonia

A Phase 4 interventional study of Cefditoren pivoxil 400mg in COVID-19 Pneumonia, sponsored by Meiji Pharma Spain S.A.. Completed at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-10-06.

Sponsored by Meiji Pharma Spain S.A. · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The global pandemic of novel coronavirus disease 2019 (COVID-19) began in Wuhan, China, in December 2019, and has since spread worldwide. The disease is mild in 85% of cases but the remaining 15% requires hospitalization and/or intensive care.

Recent publications show that a significant number of COVID-19 patients are co-infected with one or more pathogens. Most co-infections occurred within 1-4 days of onset of COVID-19 disease and a considerable number of patients arrive to the Emergency rooms with mild-moderate respiratory symptoms compatible with pneumonia of presumed bacterial origin and not severe enough for requiring hospitalization. It therefore seems reasonable to adopt therapeutic strategies for these patients that are effective and easy to follow in the outpatient setting.

Cefditoren (CDN) is a third-generation cephalosporin for oral administration. CDN has a broad spectrum of activity and is particularly active against the bacterial pathogens involved in community respiratory tract infections. Besides that, the use of CDN has been associated with a marked decrease in circulating levels of IL-6 and other pro-inflammatory cytokines and mediators of epithelial damage. The aim of this study is to demonstrate that CDN improves clinical condition in patients with mild-moderate COVID-19 and symptoms of bacterial pneumonia.

Read the detailed description

The global pandemic of novel coronavirus disease 2019 (COVID-19) began in Wuhan, China, in December 2019, and has since spread worldwide. The novel coronavirus is now referred to as severe and critical acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The disease is mild in 85% of cases but the remaining 15% requires hospitalization and/or intensive care.

Recent publications show that a variable number of COVID-19 patients are co-infected with one or more pathogens. Most co-infections occurred within 1-4 days of onset of COVID-19 disease and in a retrospective study, secondary infection was observed in 50% of non-survivor patients.

In COVID-19 patients the elevated inflammatory cytokines and other inflammatory mediators present suggest that a cytokine storm, also known as cytokine release syndrome (CRS), may play a major role in the pathology of this disease. The elevated cytokine levels, specifically IL-6, may also be responsible for the lethal complications of COVID-19. Therefore, the interleukin-6 (IL-6) blockade has been proposed as one of the strategies to manage COVID-19-induced CRS.

A considerable number of COVID-19 patients arrive to the Emergency rooms with mild-moderate respiratory symptoms compatible with pneumonia of presumed bacterial origin not severe enough for requiring hospitalization. It therefore seems reasonable to adopt therapeutic strategies for these patients that are effective and easy to follow in the outpatient setting to avoid overloading the Health System.

Cefditoren (CDN) is a third-generation cephalosporin for oral administration. CDN has a broad spectrum of activity and is particularly active against the bacterial pathogens involved in community respiratory tract infections. The results of clinical trials with CDN on community-acquired pneumonia showed percentages of clinical and microbiological efficacy around 85%. On the other hand, the use of CDN has been associated with a marked decrease in circulating levels of IL-6 and other pro-inflammatory cytokines and mediators of epithelial damage such as Krebs von den Lungen-6 (KL-6).

Considering the above and the current estate of knowledge against SARS-CoV-2, we have considered of relevance to study the efficacy of CDN in a series of patients with mild-moderate COVID-19 and with symptoms compatible with pneumonia of presumed bacterial origin, seen at the Emergency room of a public hospital and followed on outpatient basis.

02

Conditions studied

  • COVID-19 Pneumonia

Keywords

  • COVID-19
  • pneumonia
  • cefditoren
  • outpatient
03

In context

COVID-19

7,640 studies on the registry are indexed under COVID-19; 488 are open to participants now.

This study's enrollment of 20 is below the median of 100 across 4,099 interventional studies indexed under COVID-19.

Browse COVID-19 studies →

Lead sponsor

This is the only study on the registry with Meiji Pharma Spain S.A. 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

Inclusion criteria

  • Adult ≥18 years
  • Positive for SARS CoV-2
  • Radiological and clinical signs of mild-moderate pneumonia
  • Fever ≥37.7 ºC
  • Sat O2> 94% and respiratory rate \<24 on admission
  • Able of taking oral medication
  • HIV negative
  • Written and signed consent

Exclusion criteria

Exclusion Criteria:

  • Concomitant treatments with drugs of demonstrated or potential action against SARS CoV-2 within the previous 24 hours.
  • Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST) > 5 times the upper limit
  • corrected QT (QTc) interval prolongation> 450 msg,
  • Moderate or severe renal impairment (creatinine\<50ml/min)
  • Severe hepatic impairment (Child-Pugh C)
  • Pregnancy or childbearing
  • Allergy to penicillin or any other beta-lactam
  • Primary carnitine deficiency
  • Malabsorption or swallowing problems
  • Inability to understand and follow study procedures
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (actual)

Study arms

  • Experimental
    Cefditoren pivoxil 400mg

    Cefditoren pivoxil 400mg bid for 7 days

    Drug: Cefditoren pivoxil 400mg

Interventions

  • DrugCefditoren pivoxil 400mg

    Cefditoren pivoxil 400mg bid for 7 days

    Also known as: CDN-PI 400mg

06

What researchers measure

Primary outcomes

  1. Evolution of patient status

    Evolution of the status of the patient defined by the World Health Organization Ordinal Scale for Clinical Improvement for COVID-19. This is a 0-8 score where higher scores mean a better or worse outcome.

    Time frame: 28 days

  2. Assessment of Clinical improvement

    Evaluation of clinical condition through a Clinical Improvement questionnaire.

    Time frame: 28 days

Secondary outcomes

  1. Additional visit to the Emergency room

    New attendance to the hospital due to worsening

    Time frame: 28 days

  2. Need for hospitalization

    Hospitalization due to worsening

    Time frame: 28 days

  3. Occurrence of adverse events

    Adverse reactions

    Time frame: 28 days

07

Study locations

1 site
  • HU Henares
    Coslada, Madrid 28822, Spain
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 6, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04709172
Lead sponsor
Meiji Pharma Spain S.A.
Responsible party
Sponsor
First posted
Jan 14, 2021
Start date
Jan 5, 2021
Primary completion
Aug 15, 2021
Completion
Aug 15, 2021
Last update
Oct 6, 2021

Study contacts

Cristóbal Rodríguez Leal, Dr
principal investigator · HU Henares

Oversight

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

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This study is completed, as verified in Jan 2021. You cannot join it, but the record below documents what was studied.

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