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Necrotizing EnterocolitisPhase 1/2NCT00621192

Pharmacokinetic (PK) and Safety Study of Meropenem in Young Infants With Intra-abdominal Infections

A Phase 1/2 study testing meropenem in people with Necrotizing Enterocolitis and Intra-abdominal Infection, run by The Emmes Company, LLC at 26 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Meropenem is an antibiotic that is commonly used to treat serious infections. Although it is used in premature and young infants, the correct dose is not known. The purpose of this study is to determine the correct dose and the safety of meropenem for the treatment of complicated intra-abdominal infections in these… Read more about this study

Who is it for?
Ages Up to 90 days
What is being tested?
meropenem
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
26 sitesUnited States
Study dates
Jun 2008to Oct 2009
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 90 days
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Written permission from parent or legal guardian
  • Age younger than 91 days
  • Likely to survive beyond the first 48 hours after enrollment
  • Sufficient intravascular access (either peripheral or central) to receive study drug.
  • AND ONE OF THE FOLLOWING
  • 1) Physical, radiological, and/or bacteriological findings of a complicated intra-abdominal infection. These include peritonitis, NEC (Necrotizing Enterocolitis) Grade II or higher by Bell's criteria, Hirschsprung's disease with perforation, spontaneous perforation, meconium ileus with perforation, bowel obstruction with perforation, as evidenced by free peritoneal air on abdominal radiograph, intestinal pneumatosis or portal venous gas on abdominal radiographic examination.
  • OR 2) Possible NEC OR 3) Otherwise receiving meropenem per local standard of care

Who cannot join

  • Renal dysfunction evidenced by urine output <0.5 mL/hr/kg over the prior 24 hours
  • Serum creatinine >1.7 mg/dL
  • History of clinical seizures or EEG (Electroencephalogram) confirmed seizures
  • Concomitant treatment with another carbapenem (ertapenem or imipenem) at the time of informed consent
  • Any condition which would make the subject or the caregiver, in the opinion of the investigator, unsuitable for the study

Trial locations and contacts

26 sites in 1 country.

26 sites in 1 country

United States26 sites
  • Akron Children's Hospital

    Akron, Ohio, 44308

  • Albany Medical Center

    Albany, New York, 12208

  • University of Michigan

    Ann Arbor, Michigan, 48109

  • University of Alabama

    Birmingham, Alabama, 35233

  • Suny Downstate Medical Center

    Brooklyn, New York, 11203

  • Case Western Reserve, RB&C, UHCMC

    Cleveland, Ohio, 44106

  • University of Texas Southwestern Medical Center

    Dallas, Texas, 75390

  • Duke University Medical Center

    Durham, North Carolina, 27708

  • Duke University

    Durham, North Carolina, 27715

  • Evanston Northwestern Healthcare

    Evanston, Illinois, 60056

  • University of Florida

    Gainesville, Florida, 32610

  • Kapiolani Medical Center for Women and Children

    Honolulu, Hawaii, 96826

  • Baylor College of Medicine

    Houston, Texas, 77030

  • Indiana University - Riley Hospital for Children

    Indianapolis, Indiana, 46202

  • Kansas City Children's Mercy Hospital

    Kansas City, Missouri, 64108

  • University of Louisville

    Louisville, Kentucky, 40202

  • Vanderbilt Children's Hospital

    Nashville, Tennessee, 37232

  • Yale New Haven Hospital

    New Haven, Connecticut, 06510

  • Children's Hospital of Oakland

    Oakland, California, 94609

  • Children's Hospital of Orange County

    Orange, California, 92868

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Magee Women's Hospital

    Pittsburgh, Pennsylvania, 15213

  • University of Utah medical Center

    Salt Lake City, Utah, 84108

  • University of California Medical Center

    San Diego, California, 92117

  • Sharp-Mary Birch Hospital for Women

    San Diego, California, 92123

  • Children's National Medical Center

    Washington D.C., District of Columbia, 20010

Other trials in United States

About this study

Official title: Multiple Dose Pharmacokinetic Study of Meropenem in Young Infants (<91 Days) With Suspected or Complicated Intra-abdominal Infections

Meropenem is an antibiotic that is commonly used to treat serious infections. Although it is used in premature and young infants, the correct dose is not known. The purpose of this study is to determine the correct dose and the safety of meropenem for the treatment of complicated intra-abdominal infections in these young babies.

Read the detailed description

This study will evaluate the safety, tolerability and Pharmacokinetics - Pharmacodynamics (PK-PD) of meropenem in infants <91 days of age with suspected and complicated intra-abdominal infections.

The specific aims of this trial are:

  1. To characterize meropenem single-dose and multiple-dose PK in subjects with suspected and complicated intra-abdominal infections.
  2. To characterize the safety profile of meropenem in the treatment of suspected and complicated intra-abdominal infections.
  3. To assess collected efficacy data for meropenem for the treatment of suspected and complicated intra-abdominal infections.
Being tested
meropenem
Keywords
meropenem, infants, intra-abdominal infection, pharmacokinetics, safety
Medical subject headings
Enterocolitis, Necrotizing, Intraabdominal Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • meropenemDrug

    Also called Merrem

    Meropenem was administered concomitantly with compatible medications. Because an in-line filter is not appropriate due to drug binding, the 30 minute infusion was rate controlled by using appropriate infusion (syringe) pumps. Dosing and administration of other antimicrobial therapy (e.g., an aminoglycoside) was administered per local standard of care at the discretion of the infant's neonatologist. If there was a delay in the study drug shipment, sites were to use open-label meropenem to protect the safety of the participant.

    20 mg/kg every 12 hours in infants <32 weeks GA and PNA < 2 weeks 20 mg/kg every 8 hours in infants <32 weeks GA and PNA ≥ 2 weeks 20 mg/kg every 8 hours in infants ≥32 weeks GA and PNA < 2 weeks 30 mg/kg every 8 hours in infants ≥32 weeks GA and PNA ≥ 2 weeks

Study groups in NCT00621192
Study groupRoleWhat they receive
MeropenemExperimentalThese Participants were subdivided into the following four groups based on Gestational Age (GA) and Postnatal Age (PNA): Group 1: GA at birth below 32 weeks - PNA <2 weeks; Group 2: GA at birth below 32 weeks - PNA ≥2 weeks and <91 days; Group 3: GA at birth 32 weeks or older - PNA <2 weeks; Group 4: GA at birth 32 weeks or older - PNA ≥2 weeks and <91 days.
Receives: Drug: meropenem

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Efficacy Success (Alive at Efficacy Visit,Last Culture (if Obtained) From Sterile Body Fluid is Negative for Bacteria (Except Staphylococcus Species) From Start of Study Drug Until Efficacy Visit,Presumptive Clinical Cure Score(PCCS) >7 at Efficacy Visit)

    The PCCS was derived by comparing clinical signs and symptoms prior to administration of the first dose of study drug and study Day 28.The elements of the PCCS include Mean BP,Temp,PaO2(mmHg)/FiO2,Lowest serum pH,seizures,Urine output,Cardiovascular inotrope support,C-reactive protein (CRP)and Abdominal girth.

    Score - Asymptomatic to Asymptomatic 1;Asymptomatic to Worsening 0;Symptomatic to Worsening 0;Symptomatic to No change 0;Symptomatic to Improved 1;Symptomatic to Asymptomatic 1

    If 7 or more of 10 signs received a score of 1, then the infant was considered a presumptive clinical cure.

    GA stands for Gestational Age and PNA stands for Postnatal Age.

    Measured: Average of 12 days (3 to 21 days)

  2. Deaths

    Measured: Up to 51 days (Recorded from the time of informed consent until 72 hours following the last dose of study drug)

  3. Meropenem Clearance

    Given the limited availability of blood for Pharmacokinetic (PK) assessments in this population a sparse sampling approach was utilized. Subjects were assigned to one of two Dose 1 sample collection schedules, "PK-odd" and "PK-even" based on birth date to ensure collection of PK data throughout the dose interval. In addition, PK samples were collected around approximately the 5th dose. Subjects that did not have Dose 1 PK samples could have steady-state (Dose 5) using the Dose 5 PK collection schedule.

    Measured: Up to 7-8hrs post drug administration

  4. Key Safety Endpoints

    Safety assessments included death, seizure documentation (including correlation of serum meropenem level and seizures), strictures, perforation, wound dehiscence, short gut, development of extended beta lactamase infection, development of candidiasis, antimicrobial therapy failure

    Measured: Up to 51 days (Adverse Events (AEs) were recorded from the time of informed consent until 72 hours following the last dose of study drug)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Feb 2008 (estimated)
  2. Study startJun 2008
  3. Primary completionOct 2009
  4. Study completionOct 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00621192
Sponsor's protocol ID
HHSN267200700051C
Other IDs
HHSN267200700051C
Status last verified
Mar 2023
First submitted
20 Feb 2008
Last updated
25 Apr 2023
Data monitoring committee
Yes

Publications

  • Cohen-Wolkowiez M, Poindexter B, Bidegain M, Weitkamp JH, Schelonka RL, Randolph DA, Ward RM, Wade K, Valencia G, Burchfield D, Arrieta A, Mehta V, Walsh M, Kantak A, Rasmussen M, Sullivan JE, Finer N, Rich W, Brozanski BS, van den Anker J, Blumer J, Laughon M, Watt KM, Kearns GL, Capparelli EV, Martz K, Berezny K, Benjamin DK Jr, Smith PB; Meropenem Study Team. Safety and effectiveness of meropenem in infants with suspected or complicated intra-abdominal infections. Clin Infect Dis. 2012 Dec;55(11):1495-502. doi: 10.1093/cid/cis758. Epub 2012 Sep 5.

    PubMed 22955430

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing meropenem in people with Necrotizing Enterocolitis and Intra-abdominal Infection, run by The Emmes Company, LLC at 26 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 26 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Nov 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Efficacy Success (Alive at Efficacy Visit,Last Culture (if Obtained) From Sterile Body Fluid is Negative for Bacteria (Except Staphylococcus Species) From Start of Study Drug Until Efficacy Visit,Presumptive Clinical Cure Score(PCCS) >7 at Efficacy Visit) (time frame: Average of 12 days (3 to 21 days)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00621192, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Apr 2023.

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