Clinical trial NCT00100126: APC-231 Once a Day (QD) for 7 Days vs. Penicillin Taken Four Times a Day (QID) in Pediatric Patients With Strep Throat
Official title: A Phase III, Investigator Blind, Randomized, Multicenter Study to Evaluate the Efficacy and Safety of APC-231 Sprinkle QD for 7 Days vs Penicillin VK 10 mg/kg QID for 10 Days in Pediatric Patients With Streptococcus Pyogenes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Pharyngitis
Keywords: Pharyngitis
Strep throat
Lead sponsor: Advancis Pharmaceutical Corporation
Sponsor class: INDUSTRY
First posted: 2004-12-24
Enrollment: 500
Sex: ALL
Minimum age (years): 6
Maximum age (years): 12
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate the efficacy and safety of APC-231 QD for 7 days in the bacteriological outcome at the Test of Cure Visit.


Eligibility criteria: Inclusion Criteria:

Give informed consent, assent, and documentation of patient authorization for disclosure of study results.

Since all patients are below the legal age of consent, assent from the patient must be obtained (as applicable following state regulations) and written informed consent obtained from the parent or legal guardian.

* Age \> = 6 months -12 years.
* A clinical diagnosis of acute tonsillitis and/or pharyngitis defined as having the clinical signs and symptoms compatible with tonsillitis and/or pharyngitis, including sore throat or difficulty feeding or swallowing or irritability that suggests the presence of a sore throat with at least one of the following:

  * Tonsillar or pharyngeal exudate
  * Tender cervical lymph nodes
  * Fever or history of fever treated with antipyretics
  * Odynophagia
  * Uvular edema
  * Pharyngeal Erythema of moderate or greater intensity
  * Elevated white blood cell (WBC) \>12,000/mm3 or 10% bands
  * Red tongue and prominent papillae (Strawberry tongue)
* A positive rapid screening test for S. pyogenes (enzyme immunoassay; SiGNIFY™ Strep A Test).
* Patient is an appropriate candidate for oral antibiotic therapy and can swallow the study dosage forms.
* Females must be non-lactating and:

  * If of childbearing potential and sexually active, the patient must have a negative prestudy urine pregnancy test and be utilizing acceptable birth control methods throughout the study.

Exclusion Criteria:

* Chronic or recurrent (two weeks duration two times per year) odynophagia or enlarged tonsils secondary to viral or proven bacterial etiology.

  * The need for hospitalization or I.V. antimicrobial therapy.
  * Pharyngitis known or suspected to be due to a pathogen resistant to beta-lactam antimicrobials.
  * Patients who are known carriers of S. pyogenes.
  * Previous allergy, serious adverse reaction to, or intolerance to, penicillin or any other member of the beta-lactam class of antimicrobials.
  * Any serious illness or concomitant condition that the investigator judges would preclude the study evaluations or make it unlikely that the course of study therapy and follow-up could be completed. This would also include:
* Any rapidly progressive underlying disease with a shortened life expectancy.
* The inability to swallow the study dosage form.
* Unable to understand the requirements of the study.
* Neutropenia (\<1000 PMNs/mm3) or other known immunocompromised state.
* Hard chills or rigors.

  * Seizure disorder or lowered seizure threshold. This does not exclude children with previous febrile seizures.
  * Psychiatric condition requiring use of major tranquilizers.
  * Pregnancy or nursing.
  * Expectation that additional effective systemic antibacterials would be required for any condition during the duration of the study.
  * Current drug or alcohol abuse.
  * Receipt of any experimental drug or medical device within the previous 30 days (or are scheduled to receive any other experimental procedures during the study period).
  * Previous treatment under this protocol.
  * Systemic antimicrobial therapy with benzathine penicillin within 30 days or azithromycin within 14 days.
  * Hospitalization within the month prior to study admission, during which antibacterial therapy was administered.
  * The presence of clinically significant hematologic conditions or cardiac valvular disease.
  * History of cardiovascular disease, renal disease, or neurological disease secondary to previous infection with S. pyogenes.
  * Probenecid treatment or systemic steroids during the duration of the study.

Primary outcomes:
measure: Bacteriological outcome at Test of Cure Visit
Secondary outcomes:
measure: Bacteriological outcome at Late Post Therapy Visit
measure: Clinical Outcomes
measure: Safety
Other outcomes:
Locations:
city: Simpsonville
country: United States
state: South Carolina
city: Salt Lake City
country: United States
facility: Institute for Neuroscience Research
state: Utah
Study officials:
affiliation: Advancis Pharmaceutical Corp
name: Susan Clausen, PhD
role: STUDY_DIRECTOR
References: