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RecruitingNCT06921213Cares-1Updated Oct 22, 2026

Comprehensive Ambulatory Antibiotics for the Treatment of Congenital Syphilis

A Phase 2 interventional study of Linezolid (LZD) and Amoxicillin in Syphilis, Congenital, sponsored by London School of Hygiene and Tropical Medicine. Recruiting at 3 sites in 3 countries. Open to participants aged 0 Days to 7 Days. Per ClinicalTrials.gov, last updated 2026-10-22.

Sponsored by London School of Hygiene and Tropical Medicine · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started May 2026; still recruiting 6 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
90
Allocation
Randomized
Ages
0 Days to 7 Days
Sex
All
01

Study summary

CARES-1 is a randomised, open-label, phase II pharmacokinetic (PK) and safety study of ambulatory antibiotics for the treatment of neonates with "all-risk" asymptomatic congenital syphilis.

02

Conditions studied

  • Syphilis, Congenital
03

In context

Lead sponsor

London School of Hygiene and Tropical Medicine is the lead sponsor of 298 studies on the registry; 15 are open to participants now.

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

04

Who can participate

Ages eligible
0 Days to 7 Days
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

  1. Infants at risk of congenital syphilis at birth defined as:

    1. an infant born to a mother who tests positive for syphilis in pregnancy using registered and licensed locally-available diagnostic tests for example but not limited to a Treponemal rapid POCT, an RPR or both.

      AND

    2. the mother is untreated in the current pregnancy defined as:

    i. she tested positive at antenatal care and received no treatment OR ii. she was never tested during antenatal care OR iii. she tested negative at antenatal care and positive on re-testing at delivery

    OR c. the mother is inadequately treated in the current pregnancy defined as:

    i. Having received a non-penicillin based treatment regimen; and/or ii. Does not have documentation of 3 doses of IM Benzathine Penicillin, given 7-10 days apart, with the last dose given > 30 days prior to delivery OR b. The mother was adequately treated in the current pregnancy BUT considers herself at risk of re-infection following a midwife delivered explanation of risk (partner treatment, multiple partners etc).

  2. Infants who are asymptomatic for a diagnosis of congenital syphilis following application of a clinical proforma by the study team (Appendix 1)
  3. Infants who are less than \<= 7 days of life AND with a post-menstrual age (PMA) of 34-42 weeks (Appendix 2).
  4. Infants who are tolerating enteral feeds, including if they are being administered by an NG tube.

Exclusion criteria

Exclusion Criteria:

- 1. The infant's clinical condition at birth or prior to randomisation requires ongoing (> 48 hours) treatment with antibiotics with the potential for anti-treponemal activity i.e. B-lactams, Cephalosporins, Carbapenems.

2. They have a birthweight \<2kg 3. They are nil by mouth. 4. They have a life-limiting congenital anomaly

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
90 participants (estimated)

Study arms

  • Experimental
    Oral Linezolid

    10 day course of Linezolid twice a day

    Drug: Linezolid (LZD)

  • Experimental
    Oral Amoxicillin

    10 day course of Amoxicillin twice a day

    Drug: Amoxicillin

  • Active comparator
    IM Benzathine penicillin

    Single IM dose of IM Benzathine penicillin

    Drug: Benzathine Penicillin G

Interventions

06

What researchers measure

Primary outcomes

  1. Time above MIC in serum

    Time above MIC of T. pallidum for the dosing interval in serum

    Time frame: From enrolment through to day 10 of the study

  2. Time above MIC in CSF

    Time above MIC in CSF throughout the dosing interval

    Time frame: 10 days

  3. Adverse Events

    The proportion of individuals experiencing an adverse event through to week 24. The trial will record SAE, SUSARS, and drug related AEs of grade 3 or higher.

    Time frame: Assessed from enrolment through to 24 weeks

Secondary outcomes

  1. Clinical Outcome

    Proportion of infants who have clinical or laboratory evidence of congenital syphilis as adjudicated by an expert committee, blinded to treatment allocation, based on clinical and laboratory data.

    Time frame: Enrolment through to week 24

  2. AUC/MIC Ratio in serum

    Proportion of individuals achieving an AUC/MIC ratio ≥100 in serum

    Time frame: Enrolment through to day 10

  3. AUC/MIC Ratio in CSF

    Proportion of individuals achieving an AUC/MIC ratio ≥100 in CSF

    Time frame: Enrolment through to day 10

07

Study locations

3 of 3 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — At completion of the study an anonymised dataset will be deposited in an appropriate repository to facilitate sharing of IPD.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Following completion of the study

Access criteria: Data will be available via a repository to other researchers

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started May 2026 (actual). Primary completion is estimated for Mar 2027, 10 months after the start.

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

Registered
Mar 25, 2025
First posted
Apr 10, 2025
StartActual
May 4, 2026
Primary completionEst.
Mar 31, 2027
CompletionEst.
Jun 30, 2027
Last update
Oct 22, 2026
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.
Minor edits
Nothing that changes what the study is or who can join. Edited: arm descriptions
1 update, last Oct 22, 2026
Show all 1 update
  1. Oct 22, 2026
    Minor edits only
    + 1 other change: arm descriptions

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06921213
Collaborators
University College Dublin, University of Stellenbosch, Malawi Liverpool Wellcome Programme, University of Sydney, Murdoch Childrens Research Institute, University College, London, PHPT/AMS Laboratory, Faculty of Associated Medical Sciences, Chiang Mai University
Responsible party
Sponsor
First posted
Apr 10, 2025
Start date
May 4, 2026
Primary completion
Mar 31, 2027 (estimated)
Completion
Jun 30, 2027 (estimated)
Last update
Oct 22, 2026

Study contacts

Sarah Prentice
Contact
sarah.prentice@lshtm.ac.uk
+4420 7636 8636
Michael Marks
principal investigator · London School of Hygiene and Tropical Medicine
Bridget Freyne
principal investigator · University College Dublin

Oversight

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

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Studies of the drugs tested here: Linezolid · Amoxicillin

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