AzTrials
AzTrials

Infective EndocarditisPhase 3NCT02701608

Oral Switch During Treatment of Left-sided Endocarditis Due to Multi-susceptible Staphylococcus

A Phase 3 study testing Levofloxacin, Rifampicin and Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicine in people with Infective Endocarditis, run by University Hospital, Tours at 45 sites in France.

Completed

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

Official record
Search all trials

Trial summary

Infective endocarditis (IE) is a serious infection with a significant burden for patients and hospitals (in France, median length of hospital stay = 43 days), partly due to the long duration of intravenous (IV) antibacterial treatment recommended by international guidelines, between 4 and 6 weeks in most situations. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Infective Endocarditis
What is being tested?
Levofloxacin, Rifampicin and Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
162 participants
Where
45 sitesFrance
Study dates
29 Feb 2016to 4 Dec 2024
Phase
Phase 3
Are there results?
None posted in the registry

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Left-sided IE (Defined according to Duke criteria) on native or prosthetic valve
  • due to one isolate of Staphylococcus sp. (S. aureus or coagulase negative staphylococci, CNS) susceptible to levofloxacin and rifampicin
  • in an adult ≥18 year old
  • appropriate parenteral antibiotics treatment received for at least 10 days
  • in case of valvular surgery, appropriate parenteral antibiotics treatment received for at least 10 days after valvular surgery
  • planned duration of antibiotics will extend for at least 14 days at the time of randomisation i.e. a potential switch to oral treatment between Day 10 and Day 28 thus ensuring to have at least 14 days of oral therapy remaining in the experimental group
Show all 10Show fewer
  • apyrexia (temperature < 38°C) at each time point during the last 48 hours (at least two measures/day) at the time of randomisation
  • blood cultures have been sterile for at least 5 days at the time of randomisation
  • informed, written consent obtained from patient
  • subject covered by or having the rights to French social security

Who cannot join

  • body mass index <15 kg/m² or > 40 kg/m²
  • glomerular filtration rate < 50 ml/min/1,73m²
  • patient unable or unwilling to take oral treatment (digestive intolerance, significant malabsorption) at the time of randomisation
  • expected difficulties regarding compliance with oral antibiotic treatment or follow-up (e.g. severe cognitive impairment, severe psychiatric disease...)
  • patient without entourage to support and watch him at discharge
  • valvular surgery planned within the next 6 months
Show all 13Show fewer
  • patients with cardiac devices (pace-maker, implantable cardiac defibrillator) and suspected device-related IE (vegetation on the leads) if removal of the device was not performed
  • breast feeding or pregnant women, or women on childbearing age without effective contraception
  • expected duration of follow-up < 7 months at the time of randomisation (e.g. expected life expectancy < 7 months, patient living abroad...)
  • past medical history of IE in the last 3 months
  • other infection requiring parenteral antibiotic therapy
  • taking of an estrogen-progesterone treatment interacting with rifampicin
  • patient with contra-indication to oral antibiotics administered in the experimental arm (i.e. fluoroquinolones or rifampicin ) - including anticipated non-manageable drug interactions with rifampicin, and allergy.

Trial locations and contacts

45 sites in 1 country.

45 sites in 1 country

France45 sites
  • Service de Pathologies infectieuses et tropicales, Hôpital Nord, CHU d'Amiens

    Amiens, 80054

  • CHU ANGERS - Service des maladies infectieuses et tropicales

    Angers, 49100

  • Service des Maladies infectieuses et Tropicales, Hôpital Jean Minjoz, CHU de Besançon

    Besançon, 25030

  • Service de Réanimation médicale, Hôpital St André, CHU de Bordeaux

    Bordeaux, 33000

  • Service de Médecine interne, Hôpital Ambroise Paré, APHP

    Boulogne-Billancourt, 92104

  • Service de Cardiologie, Hôpitall Louis Pradel, Hôpitaux Est, Hospices Civils de Lyon

    Bron, 69677

  • Service Maladies Infectieuses et tropicales, Hôpital Côte de Nacre, CHU de Caen

    Caen, 14033

  • Service de Maladies infectieuses et tropicales, médecine interne, CH de Chambéry

    Chambéry, 73011

  • Service des maladies infectieuses et tropicales, Hôpital G. Montpied, CHU de Clermont-Ferrand

    Clermont-Ferrand, 63003

  • APHP Henri-Mondor - Service des maladies infectieuses et tropicales

    Créteil, 94010

  • Département d'infectiologie, Complexe Bocage, Hôpital d'enfants, CHU de Dijon

    Dijon, 21079

  • Service de Médecine interne polyvalente et neurologique CH de Douai

    Douai, 59507

  • Service de Médecine aigue spécifique, Hôpital Raymond Poincaré, APHP

    Garches, 92380

  • Service de Médecine post-urgence, infectiologie, Site de la Roche sur Yon, CHD Vendée

    La Roche-sur-Yon, 85025

  • Service de Médecine infectieuse, Hôpital Nord Michallon, CHU de Grenoble

    La Tronche, 38700

  • APHP BICETRE - Service des maladies infectieuses et tropicales

    Le Kremlin-Bicêtre, 94275

  • Service des Maladies infectieuses et tropicales, CH Le Mans

    Le Mans, 72037

  • Unité médicale d'infectiologie, Hôpital Huriez, CHU de Lille

    Lille, 59037

  • Clinique de la Sauvegarde

    Lyon, 69337

  • Service de Maladies infectieuses et tropicales, Hôpital Hôtel Dieu, CHU Nantes

    Nantes, 44093

  • Service d'Infectiologie, Hôpital de l'Archet, CHU de Nice

    Nice, 06200

  • Service des Maladies Infectieuses et Tropicales, Hôpital Carémeau, CHU de Nîmes

    Nîmes, 30029

  • Service des Maladies infectieuses, CH de Niort

    Niort, 79021

  • Service de Maladies infectieuses et tropicales, Hôpital de la Source, CHR Orléans

    Orléans, 45100

  • APHP St Antoine

    Paris, 75011

  • Service de Microbiologie, Hôpital Européen Georges Pompidou, APHP

    Paris, 75015

  • Service de Maladies infectieuses et tropicales, Hôpital Necker, APHP

    Paris, 75018

  • Service de Maladies infectieuses, parasitaires et tropicales, Hôpital Bichat, APHP

    Paris, 75018

  • Institut Mutualiste Montsouris - Service de médecine interne

    Paris, 75674

  • CH PAU - Service de Médecine interne et Maladies infectieuses

    Pau, 64000

  • Service de Médecine interne, maladies infectieuses et tropicales, CHU de Poitiers

    Poitiers, 86021

  • Infectiologie, médecine interne et médecine des voyages, CH d'Annecy

    Pringy, 74374

  • CH QUIMPER - Service d'infectiologie

    Quimper, 29107

  • Service de Médecine interne, maladies infectieuses, immunologie clinique, Hôpital R. Debré, CHU de Reims

    Reims, 51092

  • Service des maladies infectieuses et réanimation médicale, Hôpital Pontchaillou, CHU de Rennes

    Rennes, 35033

  • Service des Maladies infectieuses et tropicales, Hôpital Charles Nicolle, CHU de Rouen

    Rouen, 76031

  • CHU St Etienne - Service des maladies infectieuses et tropicales

    Saint-Priest-en-Jarez, 42270

  • Service des maladies respiratoires et infectieuses, CH de St Malo

    St-Malo, 35403

  • Service des Maladies infectieuses et tropicales, Hôpital de Purpan, CHU de Toulouse

    Toulouse, 31059

  • CHU Toulouse (Rangueil) Service de Cardiologie

    Toulouse, 31400

  • Service Universitaire des Maladies Infectieuses et du voyageur, CH de Tourcoing

    Tourcoing, 59208

  • Service de Médecine interne et maladies infectieuses, Hôpital Bretonneau, CHU de Tours

    Tours, 37044

  • Service de Maladies infectieuses et tropicales, Hôpitaux de Brabois, CHU de Nancy

    Vandœuvre-lès-Nancy, 54511

  • Consultation de Médecine Interne, maladies infectieuses et tropicales, CH intercommunal de Villeneuve St Georges

    Villeneuve-Saint-Georges, 94190

  • Médipôle Lyon Villeurbanne

    Villeurbanne, 69625

Other trials in France

About this study

Official title: Oral Switch During Treatment of Left-sided Endocarditis Due to Multi-susceptible Staphylococcus (Relais Oral Dans le Traitement Des Endocardites à Staphylocoques Multi-sensibles)

Infective endocarditis (IE) is a serious infection with a significant burden for patients and hospitals (in France, median length of hospital stay = 43 days), partly due to the long duration of intravenous (IV) antibacterial treatment recommended by international guidelines, between 4 and 6 weeks in most situations.

A recent survey of practices regarding the management of IE in France showed that a switch from IV to oral antibiotics is feasible, when patients with left-sided Staphylococcus IE are stable after an initial course of IV antibiotic treatment, with or without valvular surgery.

Read more

These practices have not been associated with unfavourable outcome, while significantly reducing the duration and cost of hospitalization, the risk of nosocomial infection, and patients' discomfort.

There has been no randomized controlled trial (RCT) in the field of IE over the last 20 years; current guidelines are mostly based on expert advice, in vitro studies, animal experiments, or clinical studies performed before the 90's.

The RODEO 1 project is an unprecedented opportunity to bring back evidence-based medicine in the field of IE.

Most experts acknowledge that the pharmacological PK/PD characteristics of antibiotics such as fluoroquinolones and rifampicin allow a high level of efficacy in the treatment of IE when orally administrated after an IV period of induction.

It's needed to conduct RCTs that clearly demonstrate the clinical non-inferiority of this strategy for multisusceptible staphylococci with a benefit regarding costs.

The RODEO 1 project corresponds to one pragmatic trial assessing the impact of a switch strategy, making it a comparative effectiveness trial that should be able to feed the next revision of IE international guidelines and to change practices in IE management.

Read the detailed description

The RODEO 1 study is designed to determine the safety and efficacy of partial oral treatment of IE compared with traditional full-length parenteral treatment. Our primary objective is to demonstrate that in patients with left-sided multi-susceptible Staphylococcus who have received at least 10 days of IV antibiotic treatment with or without valvular surgery, a switch to an oral combination of rifampicin and fluoroquinolones between Day 10 and Day 28 after initiation of the IV antibiotic treatment, is not inferior to the continuation of the conventional IV antibiotic treatment regarding to treatment failure within 3 months after the end of antibiotic treatment.

Nationwide, noninferiority, multicenter, randomized, controlled, open-label trials.

Randomisation will only be offered to patients who have received at least 10 days of IV conventional antibiotic treatment of IE, and fulfil the inclusion criteria.

Randomisation will take place between Day 10 and Day 28 after initiation of parenteral antibiotic therapy or valvular surgery, thus ensuring to have at least 14 days of oral therapy in the experimental group.

Patients will be eligible whether they have undergone valvular surgery or not. This will imply that surgery procedure prior to randomisation will be heterogeneous, but randomisation will be stratified on the requirement of valvular surgery as part of the treatment of the current episode of IE or not.

Being tested
Levofloxacin, Rifampicin, Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicine
Medical subject headings
Endocarditis

What participants receive

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

  • LevofloxacinDrug

    Also called Fluoroquinolones

    levofloxacin 500 mg x1/day (for patients ≤70kg) or levofloxacin 750 mg x1/day (for patients >70kg)

  • RifampicinDrug

    rifampicin 600mg x1/day (for patients ≤70kg) or rifampicin 900mg x1/day (for patients >70kg)

  • Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicineProcedure or surgery

    Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicine

Study groups in NCT02701608
Study groupRoleWhat they receive
Oral switch treatmentExperimentalOral switch to the combination of levofloxacin and rifampicin
Receives: Drug: Levofloxacin; Drug: Rifampicin
Conventional IV treatment according to european guidelinesActive comparatorConventional IV treatment of staphylococci IE (European guidelines 2015)
Receives: Procedure: Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicine

What is being measured

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

  1. Treatment failure

    Failure is a composite outcome defined by death from all causes and/or symptomatic embolic events and/or unplanned valvular surgery and/or a microbiological relapse (with the primary pathogen).

    Measured: up to 3 months after the end of antibiotic treatment

Secondary outcomes (18)
  1. death from all-cause

    death from all-cause

    Measured: up to 6 months after the end of antibiotic treatment

  2. number of symptomatic embolic events

    secondary osteo-articular, splenic or brain localization

    Measured: up to 6 months after the end of antibiotic treatment

  3. unplanned valvular surgery

    unplanned valvular surgery

    Measured: up to 6 months after the end of antibiotic treatment

  4. relapse of positive blood cultures

    relapse of positive blood cultures with the primary pathogen

    Measured: up to 6 months after the end of antibiotic treatment

  5. microbiological relapse with a different pathogen from the primary pathogen

    Relapse of positive blood cultures with a different pathogen within 3 months after the end of antibiotic therapy

    Measured: up to 6 months after the end of antibiotic treatment

  6. Echocardiography

    An apparition, an increase or decrease of the following items: vegetation, abscess, perforation, fistula, dehiscence of a prosthetic valve, will be searched at each ultrasound examination at : the end of antibiotic treatment, at 3 months and 6 months after the end of antibiotic treatment

    Measured: up to 6 months after the end of antibiotic treatment

  7. Catheter related adverse events

    Catheter-related AE: infectious (e.g. catheter-related bacteraemia) or non-infectious catheter-related complications (e.g. extravasation).

    Measured: up to 6 months after the end of antibiotic treatment

  8. other healthcare-acquired infections

    other healthcare-acquired infections, including urinary tract infections, pneumonia, surgical site infection, Clostridium difficile infections

    Measured: up to 6 months after the end of antibiotic treatment

  9. Number of participants with an antibiotic modification

    All change regarding antibiotic treatment administered will be recorded (drug, dose or duration)

    Measured: up to the end of antibiotic treatment

  10. Quality of life

    An assessment of patient's quality of life will be done at the end of antibiotic treatment, at 3 months and 6 months after the end of antibiotic treatment, using the EuroQol Five Dimensions (EQ5D3L)

    Measured: up to 6 months after the end of antibiotic treatment

  11. number of participants with a switch back from oral to IV antibiotic treatment

    For experimental group only . An assessment of the need for a return to parenteral antibiotic in the experimental group.

    Measured: up to the end of antibiotic treatment

  12. Compliance with oral antibiotic treatment

    For experimental group only. The assessment of compliance with oral antibiotic treatment will be carried out at each visit during the treatment period.

    Measured: up to 4 weeks after randomisation

  13. Cost per patient

    Analysis using data from three centers (Tours, Rennes, Nancy) to compare both strategy (oral switch vs. pan-IV) for the cost per patient

    Measured: up to 6 months after the end of antibiotic treatment

  14. Budget impact analysis (BIA)

    With data from three centers (Tours, Nancy, Rennes). With data from three centers (Tours, Nancy, Rennes). Allow to estimate the financial consequences of the adoption and diffusion of a new health intervention (the oral strategy). BIA must be calculated on a yearly basis.

    Measured: up to 6 months after the end of antibiotic treatment

  15. Utility score and incremental cost-utility ratio (ICUR)

    With data from all centers. An assessment of the health related quality of life of the patient will be carried out using a simple generic questionnaire, the EuroQol Five Dimensions (EQ5D3L), recommended by the Washington Panel on Cost Effectiveness (utility) in Health and Medicine, with a cardinal scale and validated French version (http://www.euroqol.org)Quality of life will be assessed 4 times: at baseline, at the end of antibiotic treatment, at 3 months after end of antibiotic treatment and at the final visit.

    Measured: up to 6 months after the end of antibiotic treatment

  16. Length of hospital stay

    With data from all centers. Length of hospital stay will be calculated as duration between day of start of hospitalization and day of discharge (distinguishing rehabilitation care unit). In case a patient dies during hospitalization, death will be considered as a competing event to discharge.

    Measured: up to 6 months after the end of antibiotic treatment

  17. Residual concentration of antibiotics

    Pharmacokinetic analysis for the experimental group only: residual concentrations of levofloxacin and rifampicin, or amoxicillin, after 7 days of oral treatment (i.e. at visit 2).

    Measured: 7 days

  18. Biological collection for further analysis on endocarditis

    A biological collection will be constituted in order to perform further biological and genetic analysis of endocarditis (i.e. inflammatory markers of efficacy and genetic markers that predispose to endocarditis).

    Measured: up to 6 months after the end of antibiotic treatment

Timeline

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

  1. First posted8 Mar 2016 (estimated)
  2. Study start29 Feb 2016
  3. Primary completion15 Aug 2024
  4. Study completion4 Dec 2024

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
162 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02701608
Sponsor's protocol ID
RODEO 1
Status last verified
Feb 2026
First submitted
28 Jan 2016
Last updated
12 Feb 2026
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: There are no plans to grant public access to the full protocol, participant-level data or statistical code. Data from the RODEO trials is stored by the promotor of the trial. Data and the personal identifiers are stored separately and a special permit is required for access to the data. Data can be available on request for academic researchers when it have been analysed and published. Qualified researchers can ask for data sharing by the first author LB after the study finalization. Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/

Publications

  • Lemaignen A, Bernard L, Tattevin P, Bru JP, Duval X, Hoen B, Brunet-Houdard S, Mainardi JL, Caille A; RODEO (Relais Oral Dans le traitement des Endocardites a staphylocoques ou streptOcoques) and AEPEI (Association pour l'Etude et la Prevention de l'Endocardite Infectieuse) study groups. Oral switch versus standard intravenous antibiotic therapy in left-sided endocarditis due to susceptible staphylococci, streptococci or enterococci (RODEO): a protocol for two open-label randomised controlled trials. BMJ Open. 2020 Jul 14;10(7):e033540. doi: 10.1136/bmjopen-2019-033540.

    PubMed 32665381

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Levofloxacin, Rifampicin and Conventional IV treatment of staphylococci IE following European guidelines 2015 including cloxacilline, oxacilline,gentamicine,vancomycine,rifampicine in people with Infective Endocarditis, run by University Hospital, Tours at 45 sites in France.

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 10 inclusion and 13 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 12 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 45 sites in France. 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 phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Treatment failure (time frame: up to 3 months after the end of antibiotic treatment). 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 NCT02701608, 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 12 Feb 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in