Gram-Negative Bloodstream Infection Oral Antibiotic Therapy Trial
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Intravenous Antibiotics, Oral Antibiotics.
- Кому может быть актуально
- Состояния в реестре: Gram-negative Bacteremia. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
The Gram-negative bloodstream infection Oral Antibiotic Therapy trial (The GOAT Trial) is a multi-center, randomized clinical trial that hypothesizes that early transition to oral antibiotic therapy for the treatment of Gram-Negative BloodStream Infection (GN-BSI) is as effective but safer than remaining on intravenous (IV) antibiotic therapy for the duration of treatment.
Подробное описание
This is an open-label, pragmatic, randomized trial of approximately 1,204 adult patients hospitalized across 9 United States hospitals with the overarching goal of determining whether the optimal approach for the management of GN-BSI is (1) IV antibiotics for the duration of treatment or (2) initial IV antibiotics followed by early transition to oral antibiotics for the duration of treatment. Patients will be randomized in a 1:1 ratio to remain on IV antibiotics or transition to oral antibiotics as soon as possible after blood culture collection, but no more than 5 days later. The primary objective is to compare the Desirability of Outcomes Ranking (DOOR) distributions between patients with GN-BSI receiving IV antibiotic treatment only versus patients transitioned early to oral antibiotic treatment. The study hypothesis is that oral treatment will result in a more favorable DOOR distribution than IV treatment, likely as a result of differential adverse events and changes in Quality of Life (QoL) profiles.
Вмешательства
- Препарат Intravenous Antibiotics
Participants will continue to receive intravenous antibiotics until the completion of the treatment course - Препарат Oral Antibiotics
Participants will transition to oral antibiotics at the time of randomization and will continue oral antibiotics until the completion of the treatment course
Первичные конечные точки
- Desirability of Outcome Ranking (DOOR) [Срок оценки: Day 30]
Вторичные конечные точки (4)
- Incidence of All Cause Mortality [Срок оценки: Day 30]
- Frequency of Recurrent infection [Срок оценки: Day 30]
- Length of stay (days) [Срок оценки: Day 30]
- Number of Participants with Treatment-related adverse events [Срок оценки: Day 30]
Критерии участия
Критерии включения
- Adult (≥ 18 years) at the time of screening
- Hospitalized
- Identification of at least one Gram-negative organism in a blood culture
- Capable of providing written informed consent (includes through a legally authorized representative)
- Willingness to adhere to assigned study arm
- Capable and willing to complete a follow-up QoL interview (including through a legally authorized representative)
Критерии исключения
- Unable to tolerate or absorb a course of oral antibiotics
- Actively receiving vasopressors
- Gram-negative organism not susceptible to any oral antibiotics
- Gram-negative organism not susceptible to any IV antibiotics
- Polymicrobial bloodstream infection
- The following patients with polymicrobial infections remain eligible for enrollment: (1) more than one morphology or species of a gram-negative organism (except for Acinetobacter baumannii or Stenotrophomonas maltophilia), (2) a single positive blood culture with a common commensal organism (grown in addition to an Enterobacterales species or Pseudomonas aeruginosa
- Allergy or contraindication rendering no oral option or no IV option for therapy with the listed antibiotic agents.
- Anticipated duration of therapy greater than 14 days
- Central nervous system infection
- Absolute neutrophil count of <500 cells/mL or anticipated to reduce to <500 cells/mL during the antibiotic treatment course.
- Receiving hospice care
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Открытое
- Основная цель
- Лечение
Центры проведения
США · 11 центров
- University of California, San Francisco — San Francisco
- Denver Health Hospital Authority — Denver
- University of Maryland Medical Center — Baltimore
- Johns Hopkins University Hospital Systems — Baltimore
- Mayo Clinic — Rochester
- Rutgers-RWJ University Hospital — New Brunswick
- Duke University — Durham
- Hospital of the University of Pennsylvania — Philadelphia
- … и ещё 3 центра
Идентификаторы
NCT: NCT06080698 · IRB00390397 · CER-2022C1-26099