Clinical trial NCT02739997: Study of Ceftolozane/Tazobactam (MK-7625A) in Combination With Metronidazole in Japanese Participants With Complicated Intra-abdominal Infection (MK-7625A-013)
Official title: A Multicenter, Open-label, Noncomparative, Japanese Phase III Study to Assess the Efficacy and Safety of Ceftolozane/Tazobactam (MK-7625A) Used in Combination With Metronidazole in Japanese Patients With Complicated Intra-abdominal Infection.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Intra-abdominal Infection
Complicated Intra-abdominal Infection
Lead sponsor: Merck Sharp & Dohme LLC
Sponsor class: INDUSTRY
First posted: 2016-04-15
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This is a Phase 3, multi-site, non-randomized, open-label study evaluating the safety and efficacy of MK-7625A 1.5 g (ceftolozane 1 g/tazobactam 0.5 g) plus metronidazole 500 mg for the treatment of Complicated Intra-abdominal Infections (cIAI) in Japanese participants. Efficacy will be primarily assessed by clinical response defined as complete resolution or significant improvement in signs and symptoms of the index infection.


Eligibility criteria: Inclusion Criteria:

* Has one of the following diagnoses with evidence of intra-peritoneal infection: cholecystitis (including gangrenous cholecystitis) with rupture, perforation, or progression of the infection beyond the gallbladder wall; diverticular disease with perforation or abscess; appendiceal perforation or periappendiceal abscess; acute gastric or duodenal perforation, traumatic perforation of the intestine; peritonitis due to perforated viscus or following a prior operative procedure; or Intra-abdominal abscess (including liver and spleen).
* Has evidence of systemic infection
* Had or has plans to have surgical intervention within 24 hours of the first dose of study drug
* Has radiographic evidence of perforation or abscess if enrolled preoperatively
* Is able to have intra-abdominal specimen taken at baseline for the microbiological assessment
* Female participants of child bearing potential must not be pregnant (negative human chorionic gonadotropin test) or breastfeeding and must agree to use adequate contraception for the duration of the study and up to 35 days after the last dose of study drug
* Male participants must agree to use adequate contraception for the duration of the study and up to 75 days after the last dose of study drug

Exclusion Criteria:

* Has simple appendicitis; abdominal wall abscess; small bowel obstruction or ischemic bowel disease without perforation; spontaneous bacterial peritonitis associated with cirrhosis and chronic ascites; acute suppurative cholangitis; infected necrotizing pancreatitis; pancreatic abscess; infectious mononucleosis; cystic fibrosis; or pelvic infections
* Has complicated intra-abdominal infection managed by staged abdominal repair (STAR) or open abdomen drainage
* Has had acute gastric or duodenal perforation (≤ 24 hours after) or traumatic perforation of the intestine (≤ 12 hours after) operated on after the perforation occurred
* Is expected to be cured by only surgical intervention without use of systemic antibacterial therapy
* Has used systemic antibacterial therapy for intra-abdominal infection for more than 24 hours prior to the first dose of study drug, unless there is a documented treatment failure with such therapy
* Has severe impairment of renal function (estimated CrCl \< 30 mL/minute), or requirement for peritoneal dialysis, hemodialysis or hemofiltration, or oliguria (\< 20 mL/hour urine output over 24 hours)
* Has a concomitant infection at the time of randomization, which requires non-study systemic antibacterial therapy in addition to study drug with the exception of an antibacterial with Gram-positive activity only (vancomycin, teicoplanin, linezolid and daptomycin)
* Has used any postoperative non-study antibacterial therapy if enrolled preoperatively
* Has used more than 1 dose of non-study antibacterial therapy following surgery if enrolled postoperatively
* Has hepatic disease
* Is unlikely to survive the 4 to 5 week study period
* Has organic brain or spinal cord disease
* Has any rapidly-progressing disease or immediately life-threatening illness
* Has an immunocompromising condition (i.e., AIDS, hematological malignancy, or bone marrow transplantation, or immunosuppressive therapy) or is receiving ≥ 40 mg of prednisone per day administered continuously for \> 14 days prior to study start
* Has a history of any moderate or severe hypersensitivity or allergic reaction to any beta-lactam (β-lactam) antibacterial, including cephalosporins, carbapenems, penicillins, or β-lactamase inhibitors, or metronidazole, or nitroimidazole derivatives
* Is receiving or has received disulfiram within 14 days before receiving study drug or who is currently receiving probenecid
* Has participated in any clinical study of an investigational product within 30 days prior to the first dose of study drug
* Has previously participated in any study of ceftolozane or MK-7625A.

Primary outcomes:
measure: Percentage of Participants With Clinical Response (Clinical Cure, Clinical Failure, or Indeterminate) at Test of Cure (TOC)
timeFrame: Day 28 (28 days after initiating study therapy)
measure: Percentage of Participants With Adverse Events (AEs)
timeFrame: Up to Day 42 (up to 28 days after completing study therapy)
measure: Percentage of Participants Discontinuing Study Drug Due to AEs
timeFrame: Up to Day 14
Secondary outcomes:
measure: Percentage of Participants With Clinical Response (Clinical Cure, Clinical Failure, or Indeterminate) at End Of Therapy (EOT)
timeFrame: Up to Day 14
measure: Percentage of Participants With Clinical Response (Clinical Cure, Clinical Failure, or Indeterminate) at Late Follow-Up (LFU)
timeFrame: Up to Day 42 (28 days after completing study therapy)
measure: Percentage of Participants With Microbiological Response (Eradication, Persistence, or Indeterminate) at EOT
timeFrame: Up to Day 14
measure: Percentage of Participants With Microbiological Response (Eradication, Persistence, or Indeterminate) at TOC
timeFrame: Day 28 (28 days after initiating study therapy)
measure: Percentage of Participants With Microbiological Response (Eradication, Persistence, or Indeterminate) by Pathogen at EOT
timeFrame: Up to Day 14
measure: Percentage of Participants With Microbiological Response (Eradication, Persistence, or Indeterminate) by Pathogen at TOC
timeFrame: Day 28 (28 days after initiating study therapy)
Other outcomes:
Locations:
Study officials:
affiliation: Merck Sharp & Dohme LLC
name: Medical Director
role: STUDY_DIRECTOR
References:
citation: Mikamo H, Monden K, Miyasaka Y, Horiuchi T, Fujimoto G, Fukuhara T, Yoshinari T, Rhee EG, Shizuya T. The efficacy and safety of tazobactam/ceftolozane in combination with metronidazole in Japanese patients with complicated intra-abdominal infections. J Infect Chemother. 2019 Feb;25(2):111-116. doi: 10.1016/j.jiac.2018.10.012. Epub 2018 Dec 6.