AzTrials
AzTrials

Serious Bacterial InfectionPhase 3NCT03580044

Efficacy, Safety, and Tolerability of ATM-AVI in the Treatment of Serious Infection Due to MBL-producing Gram-negative Bacteria

A Phase 3 study testing ATM-AVI and BAT in people with Serious Bacterial Infection, run by Pfizer at 42 sites in 12 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

Phase 3 study to determine the efficacy, safety, and tolerability of aztreonam- avibactam (ATM- AVI) versus best available therapy (BAT) in the treatment of hospitalized adults with complicated intra-abdominal infections (cIAI), nosocomial pneumonia (NP) including hospital acquired pneumonia (HAP) and ventilator… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Serious Bacterial Infection
What is being tested?
ATM-AVI and BAT
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
42 sitesin 12 countries
Study dates
25 Dec 2020to 23 Jan 2023
Phase
Phase 3
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject must be ≥18 years of age.
  • Evidence of a personally signed and dated informed consent document indicating that the subject or a legally acceptable representative has been informed of all pertinent aspects of the study.
  • Subjects must have a confirmed diagnosis of serious bacterial infection, specifically cIAI, HAP/VAP, cUTI, or BSI requiring administration of IV antibacterial therapy.
  • Subjects must have an MBL- positive Gram- negative bacteria (an Enterobacteriaceae and/or Stenotrophomonas maltophilia for which the imipenem or meropenem MIC is ≥ 4 µg/mL), that was isolated from an appropriate specimen obtained within 7 days prior to screening.
  • Female subject of childbearing potential must have a negative serum or urine pregnancy test, with sensitivity of at least 25 mIU/mL.
  • Subjects who have received more than 48 hours of an appropriate prior systemic antibiotic[s] for a carbapenem non -susceptible pathogen may be enrolled if they demonstrate worsening or lack of improvement of objective symptoms or signs of infection (Note: antibiotic[s] is considered appropriate if microbiological susceptibility test results show that all carbapenem non -susceptible pathogens are susceptible to the systemic antibiotic[s] received).
Show all 60Show fewer
  • Additional Inclusion Criteria- cIAI Subjects
  • Subject must have a specimen obtained from an abdominal source during a surgical intervention within 7 days prior to screening from which a study qualifying pathogen was isolated upon culture. Surgical intervention includes open laparotomy, percutaneous drainage of an abscess, or laparoscopic surgery.
  • The subject has at least 1 of the following diagnosed during the surgical intervention:
  • Cholecystitis with gangrenous rupture or perforation or progression of the infection beyond the gallbladder wall;
  • Diverticular disease with perforation or abscess;
  • Appendiceal perforation or peri-appendiceal abscess;
  • Acute gastric or duodenal perforations, only if operated on >24 hours after diagnosis;
  • Traumatic perforation of the intestines, only if operated on >12 hours after diagnosis;
  • Other secondary peritonitis (not primary/ spontaneous bacterial peritonitis associated with cirrhosis or chronic ascites);
  • Intra abdominal abscess (including of the liver and spleen provided that there is extension beyond the organ with evidence of intra peritoneal involvement).
  • Subject has at least 1 of the following signs / symptoms from each of the following 2 groups:
  • Group A: Evidence of systemic inflammatory response:
  • Documented fever (defined as body temperature ≥38°C) or hypothermia (with a rectal core body temperature ≤35°C);
  • Elevated white blood cells (WBC) (>12000 cells/µL);
  • Systolic blood pressure (SBP) <90 mmHg or mean arterial pressure (MAP) <70 mmHg, or a SBP decrease of >40 mmHg;
  • Increased heart rate ( >90 beats per minute [bpm]) and respiratory rate (>20 breaths/min);
  • Hypoxemia (defined as oxygen [O2] saturation <95% by pulse oximetry);
  • Altered mental status.
  • Group B: Physical findings consistent with intra abdominal infection, such as:
  • Abdominal pain and/or tenderness, with or without rebound;
  • Localized or diffuse abdominal wall rigidity;
  • Abdominal mass.
  • Additional Inclusion Criteria - HAP/VAP Subjects
  • Onset of symptoms >48 hours after admission or <7 days after discharge from an inpatient care facility (for which the duration of admission was >3 days).
  • New or worsening infiltrate on chest X- ray (or computerized tomography [CT]- scan) obtained within 48 hours prior to randomization.
  • At least 1 of the following:
  • Documented fever (temperature ≥38°C) or hypothermia (rectal/core temperature ≤35°C);
  • WBC ≥10,000 cells/mm3, leukopenia with total WBC ≤4500 cells/mm3, or >15% immature neutrophils (bands) noted on peripheral blood smear.
  • At least 2 of the following:
  • A new cough (or worsening of cough at Baseline);
  • Production of purulent sputum or purulent endotracheal secretions;
  • Auscultatory finding consistent with pneumonia/pulmonary consolidation (eg, rales, rhonchi, bronchial breath sounds, dullness on percussion, egophony);
  • Dyspnea, tachypnea, or hypoxemia (O2 saturation <90% or partial pressure of O2 [pO2]<60 mmHg while breathing room air);
  • Need for acute changes in the ventilator support status/system to enhance oxygenation, as determined by worsening oxygenation (arterial blood gas [ABG] or pO2 in arterial blood [PaO2]/fraction of inspired O2 [FiO2]) or needed changes in the amount of positive end expiratory pressure.
  • Subjects must have a respiratory specimen obtained within 7 days prior to screening for Gram stain and culture from which a study qualifying pathogen was isolated upon culture. This includes culture of either an expectorated sputum or a specimen of respiratory secretions obtained by endotracheal aspiration in intubated subjects, or by bronchoscopy with bronchoalveolar lavage (BAL), mini BAL or protected specimen brush (PSB) sampling.
  • Additional Inclusion Criteria - cUTI Subjects
  • Subject had urine within 7 days prior to screening that cultured positive; containing ≥10^5 colony forming unit (CFU)/mL of at least 1 carbapenem non susceptible, MBL positive Gram-negative bacteria, ie, the isolate from the study qualifying culture.
  • Subject had pyuria in the 7 days prior to screening as determined by a midstream clean catch or catheterized urine specimen with ≥10 white blood cells (WBCs) per HighPower Field (HPF) on standard examination of urine sediment or ≥10 WBCs/mm3 in unspun urine.
  • Subject demonstrates either acute pyelonephritis or complicated lower UTI without pyelonephritis as defined by the following criteria:
  • Acute pyelonephritis indicated by flank pain (which must have onset or worsened within 7 days of enrollment) or costovertebral angle tenderness on examination and at least 1 of the following: i) Fever, defined as body temperature ≥38°C (with or without patient symptoms of rigor, chills, or warmth); ii) Nausea and/or vomiting. OR b. Complicated lower UTI, as indicated by qualifying symptoms plus at least 1 complicating factor as follows: i) Qualifying symptoms: subject must have at least 2 of the following symptoms with at least 1 symptom from Group A:
  • Group A symptoms include dysuria, urgency, frequency, and or suprapubic pain;
  • Group B symptoms include fever (defined as body temperature ≥38°C with or without patient symptoms of rigor, chills, warmth), nausea, and/or vomiting.
  • Complicating factors: subject must have at least 1 of the following complicating factors:
  • Documented history of urinary retention (male subjects);
  • Obstructive uropathy that is scheduled to be medically or surgically relieved during study therapy and before the EOT;
  • Functional or anatomical abnormality of the urogenital tract, including anatomic malformations or neurogenic bladder, or with a postvoid residual urine volume of at least 100 mL;
  • Use of intermittent bladder catheterization or presence of an indwelling bladder catheter for at least 48 hours;
  • Urogenital procedure (such as cystoscopy or urogenital surgery) within the 7 days prior to obtainment of the specimen used for the study qualifying culture.
  • Additional Inclusion Criteria - BSI Subjects
  • <!-- -->
  • Subject has a confirmed diagnosis of primary BSI or catheter related BSI (CR- BSI).
  • Signs and symptoms of systemic infection characterized by at least one of the following:
  • Chills, rigors, or fever (temperature of ≥38.0°C or ≥100.4°F);
  • Elevated white blood cell count (≥10,000/mm3) or left shift (>15% immature polymorphonuclear leukocytes (PMNs)).

Who cannot join

  • History of serious allergic reaction (anaphylaxis, angioedema, bronchospasm, hypersensitivity) to any systemic antibacterial allowed per protocol.
  • Subject has a concurrent infection that may interfere with the evaluation of response to the study antibiotics.
  • Subject has a need for effective concomitant systemic antibacterials in addition to those allowed per protocol for the diagnoses under study.
  • Estimated CrCL ≤15 mL/min or anticipated requirement for dialysis during the study.
  • Additional Exclusion Criteria - cIAI Subjects
  • Subject has infections limited to the hollow viscous, such as simple cholecystitis, gangrenous cholecystitis without rupture, and simple appendicitis, or has acute suppurative cholangitis, infected necrotizing pancreatitis, or pancreatic abscess.
Show all 12Show fewer
  • Subject has abdominal wall abscess or small bowel obstruction without perforation or ischemic bowel without perforation.
  • Subject has a cIAI managed by staged abdominal repair (STAR), or "open abdomen" technique, or marsupialization. This criterion is intended to exclude subjects in whom the abdomen is left open, particularly those for whom re operation is planned.
  • Additional exclusion criteria - cUTI Subjects 1. Subjects with suspected or confirmed complete obstruction of any portion of the urinary tract, perinephric or intrarenal abscess, or prostatitis, or history of any illness that, in the opinion of the investigator, may confound the results of the study or pose additional risk in administering the study therapy to the subject.
  • 2. Any recent history of trauma to the pelvis or urinary tract.
  • Additional exclusion criteria - BSI Subjects
  • 1. Subject has a prosthetic cardiac valve or synthetic endovascular graft. 2. Subject has a suspected or documented medical condition with well-defined requirement for prolonged antibiotic treatment (eg, infectious endocarditis, osteomyelitis/septic arthritis, undrainable/undrained abscess, unremoveable/unremoved prosthetic associated infection).

Trial locations and contacts

42 sites in 12 countries.

42 sites in 12 countries

China6 sites

  • Baotou Central Hospital

    Baotou, Inner Mongolia, 014000

  • Hunan Province People's Hospital

    Changsha, Hunan, 410005

  • The First Hospital of Kunming

    Kunming, Yunnan, 650034

  • The First Hospital of Kunming

    Kunming

  • Huashan Hospital Fudan University

    Shanghai, Shanghai Municipality, 200040

  • The First Affiliated Hospital of Shantou University Medical College

    Shantou, Guangdong, 515041

Other trials in China

Greece6 sites

  • General Hospital of Athens "Evangelismos"

    Athens, 10676

  • General and Chest Diseases Hospital "Sotiria"

    Athens, 11527

  • General Hospital of Athens "Laiko",

    Athens, 11527

  • University General Hospital "ATTIKON", Medicine and Infectious Diseases

    Athens, 12462

  • University General Hospital of Heraklion

    Heraklion, Crete, 71110

  • University General Hospital of Larissa

    Larissa, 41110

Other trials in Greece

India5 sites

  • Victoria Hospital, Bangalore Medical College and Research Institute

    Bangalore, 560002

  • Apollo Hospitals Enterprise Limited

    Chennai, Tamil Nadu, 600006

  • S.R.Kalla Memorial Gastro & General Hospital

    Jaipur, Rajasthan, 302001

  • Government medical College

    Kozhikode, Kerala, 673008

  • Deenanath Mangeshkar Hospital And Research Centre

    Pune, Maharashtra, 411004

Other trials in India

Romania5 sites

  • Institutul National de Boli Infectioase "Prof. Dr. Matei Bals"

    Bucharest, 021105

  • Spitalul Clinic de Boli Infectioase si Tropicale "Dr. Victor Babes"

    Bucharest, 030303

  • Spitalul Clinic de Boli Infectioase Cluj Napoca

    Cluj-Napoca, 400348

  • Spitalul Clinic de Boli Infectioase "Sf. Parascheva" Iasi

    Iași, 700116

  • Spitalul Clinic Judetean de Urgenta "Pius Brinzeu"

    Timișoara, 300723

Other trials in Romania

Philippines4 sites

  • Davao Doctors Hospital

    Davao City, 8000

  • Makati Medical Center

    Makati City, 1229

  • Manila Doctors Hospital

    Manila, 1000

  • St. Luke's Medical Center

    Quezon City, 1112

Other trials in Philippines

Russia4 sites

  • SBHI of the city of Moscow "N.I.Pirogov City Clinical Hospital # 1"

    Moscow, 119049

  • OGBUZ "Smolensk Regional Clinical Hospital"

    Smolensk, 214018

  • FSBEI of HE "Smolensk State Medical University" of the Ministry of Health of the RF

    Smolensk, 214019

  • SRI of Antimicrobial Chemotherapy

    Smolensk, 214019

Other trials in Russia

Thailand4 sites

  • Faculty of Medicine Siriraj Hospital

    Bangkoknoi, Bangkok, 10700

  • Songklanagarind Hospital, Prince of Songkla University

    Hat Yai, Changwat Songkhla, 90110

  • Bamrasnaradura Infectious Disease Institute (BIDI)

    Muang, Changwat Nonthaburi, 11000

  • Srinagarind Hospital, Division of lnfectious Disease and Tropical Medicine

    Muang, Khonkaen, 40002

Other trials in Thailand

Taiwan3 sites

  • Kaohsiung Medical University Chung-Ho Memorial Hospital

    Kaohsiung City, 807

  • Kaohsiung Veterans General Hospital

    Kaohsiung City, 81362

  • National Taiwan University Hospital

    Taipei, 10002

Other trials in Taiwan

Malaysia2 sites

  • Hospital Kuala Lumpur

    Kuala Lumpur, Kuala Lumpur, 50586

  • University Malaya Medical Centre

    Kuala Lumpur, 59100

Other trials in Malaysia

United States1 site

  • Banner University Medical Center Tucson

    Tucson, Arizona, 85719

Other trials in United States

Argentina1 site

  • Hospital San Roque

    Córdoba, 5000

Other trials in Argentina

Mexico1 site

  • Hospital Civil de Guadalajara "Fray Antonio Alcalde"

    Guadalajara, Jalisco, 44280

Other trials in Mexico

About this study

Official title: A PROSPECTIVE, RANDOMIZED,OPEN-LABEL, COMPARATIVE STUDY TO ASSESS THE EFFICACY, SAFETY AND TOLERABILITY OF AZTREONAM- AVIBACTAM (ATM-AVI) AND BEST AVAILABLE THERAPY FOR THE TREATMENT OF SERIOUS INFECTIONS DUE TO MULTI-DRUG RESISTANT GRAM- NEGATIVE BACTERIA PRODUCING METALLO -Β-LACTAMASE (MBL)

Phase 3 study to determine the efficacy, safety, and tolerability of aztreonam- avibactam (ATM- AVI) versus best available therapy (BAT) in the treatment of hospitalized adults with complicated intra-abdominal infections (cIAI), nosocomial pneumonia (NP) including hospital acquired pneumonia (HAP) and ventilator associated pneumonia (VAP), complicated urinary tract infections (cUTI), or bloodstream infections (BSI) due to metallo-β-lactamase (MBL)- producing Gram-negative bacteria.

Read the detailed description

This is a prospective, randomized, multicenter, open-label, parallel group, comparative study to determine the efficacy, safety, and tolerability of aztreonam- avibactam (ATM- AVI) versus best available therapy (BAT) in the treatment of hospitalized adults with complicated intra-abdominal infections (cIAI), nosocomial pneumonia (NP) including hospital acquired pneumonia (HAP) and ventilator associated pneumonia (VAP), complicated urinary tract infections (cUTI), or bloodstream infections (BSI) due to metallo-β-lactamase (MBL)- producing Gram-negative bacteria.

The study will randomize approximately 60 subjects in a 2:1 randomization scheme (ATM-AVI: BAT) with infections due to MBL-producing Gram-negative bacteria. Molecular testing at the central microbiology laboratory will be performed to confirm the MBL status of the organism upon study completion or at pre-designated intervals.

The study will consist of a Screening Visit (Visit 1), a Baseline visit (Visit 2) on Day 1 of the study treatment, ongoing treatment visits (Visits 3 to 15) from Day 2 to Day 14, an End of Treatment (EOT) visit (Visit 16) within 24 hours after the last infusion, a Test of Cure (TOC) visit (Visit 17) on Day 28 (±3 days) and a Late Follow Up (LFU) visit (Visit 18) on Day 45 (±3 days).

Subjects will be stratified at randomization based on infection type (cIAI, HAP/VAP, cUTI or BSI). The number of subjects with cUTI will be no more than approximately 75% of the study population.

After obtaining written informed consent and confirming eligibility, subjects will be randomized in a 2:1 ratio to the ATM AVI treatment arm or the BAT treatment arm according to a central randomization schedule (approximately 40 (ATM AVI) and approximately 20 (BAT) subjects per group).

The duration of treatment is 5 to 14 days for cIAI, cUTI and BSI and 7 to 14 days for HAP/VAP. Each subject is expected to complete the study, including the LFU visit. The precise duration of treatment will be determined by the investigator based on the subject's severity of infection and subsequent response to treatment.

For subjects randomized to ATM AVI treatment arm, sparse blood samples will be collected for population pharmacokinetic (PK) assessments and PK/pharmacodynamic (PD) relationships will be evaluated in subjects where plasma samples and microbiological response data have been collected.

Being tested
ATM-AVI, BAT
Keywords
Serious bacterial infection, cIAI, HAP/(VAP, cUTI, BSI, MBL

What participants receive

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

  • ATM-AVICombination product

    Also called Aztreonam- Avibactam

    ATM-AVI doses (loading, extended loading and maintenance) and the dosing frequency of the maintenance dose are dependent on renal function. Subjects will be given a loading dose of 500 mg ATM plus 167 mg AVI or 675 mg ATM plus 225 mg AVI over a period of 30 minutes. This treatment will immediately be followed by an extended loading dose of 1500 mg ATM plus 500 mg AVI or 675 mg ATM plus 225 mg AVI over a period of 3 hours. Then there will be a 3 hour or 5 hour gap. Subjects will receive a maintenance dose of 1500 mg ATM plus 500 mg AVI every 6 hours or 750 mg ATM plus 250 mg AVI every 6 hours, or 675 mg ATM plus 225 mg AVI every 8 hours. Subjects with cIAI will also receive Metronidazole (MTZ) 500 mg IV q8h over 60 minutes. The first dose of MTZ will be started immediately after the extended loading dose of ATM-AVI has completed and treatment will be continued until the end of the treatment period.

  • BATDrug

    Also called Best Available Therapy

    The comparator treatment in this study is best available therapy (BAT) based upon site practice and local epidemiology. The choice of BAT (monotherapy or combination) for each subject must be recorded prior to randomization. If the chosen BAT does not provide adequate anaerobic coverage for cIAI subjects MTZ is to be administered as a co therapy. BAT dose, frequency, dose adjustments with renal impairment will be based on per local package inserts.

Study groups in NCT03580044
Study groupRoleWhat they receive
ATM- AVI Aztreonam- Avibactam (ATM-AVI) Active Treatment ArmExperimentalNot described
Receives: Combination Product: ATM-AVI
Best Available Therapy (BAT) Comparator Treatment ArmActive comparatorNot described
Receives: Drug: BAT

What is being measured

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

  1. Percentage of Participants With Clinical Cure at the Test of Cure (TOC) Visit -Microbiological Intent to Treat (Micro-ITT) Analysis Set

    Clinical cure was defined as improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for the index infection (i.e., cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. The clinical response assessment was determined by a blinded independent adjudication committee. 95% confidence interval (CI) was calculated using Jeffrey's method.

    Measured: Day 28

Secondary outcomes (19)

  1. Percentage of Participants With Clinical Cure at the TOC Visit-Microbiologically Evaluable (ME) Analysis Set

    Clinical cure was defined as improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for the index infection (i.e., cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. The clinical response assessment was determined by a blinded independent adjudication committee. 95% CI was calculated using Jeffrey's method.

    Measured: Day 28

  2. Percentage of Participants With Clinical Cure at the End of Treatment (EOT) Visit- Micro-ITT Analysis Set

    Clinical cure was defined as improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for the index infection (i.e., cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. The clinical response assessment was determined by a blinded independent adjudication committee. 95% CI was calculated using Jeffrey's method.

    Measured: Up to 24 hours after the last infusion on Day 14

  3. Percentage of Participants With Clinical Cure at the EOT Visit- ME Analysis Set

    Clinical cure was defined as improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for the index infection (i.e., cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. The clinical response assessment was determined by a blinded independent adjudication committee. 95% CI was calculated using Jeffrey's method.

    Measured: Up to 24 hours after the last infusion on Day 14

  4. Percentage of Participants With a Favorable Per Participant Microbiological Response at EOT Visit-Micro-ITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 colony forming units per milliliter [CFU/mL] for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants).

    Measured: Up to 24 hours after the last infusion on Day 14

  5. Percentage of Participants With a Favorable Per Participant Microbiological Response at TOC Visit-Micro-ITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 colony forming units per milliliter [CFU/mL] for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants).

    Measured: Day 28

  6. Percentage of Participants With a Favorable Per Participant Microbiological Response at EOT Visit-ME Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants).

    Measured: Up to 24 hours after the last infusion on Day 14

  7. Percentage of Participants With a Favorable Per Participant Microbiological Response at TOC Visit-ME Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants).

    Measured: Day 28

  8. Percentage of Pathogens According to Favourable Per-Pathogen Microbiological Response at the EOT Visit-Micro-ITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants).

    Measured: Up to 24 hours after the last infusion on Day 14

  9. Percentage of Pathogens According to Favourable Per-Pathogen Microbiological Response at the TOC Visit-Micro-ITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants).

    Measured: Day 28

  10. Percentage of Pathogens According to Favourable Per-Pathogen Microbiological Response at the EOT Visit-ME Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants). ME analysis set comprised of participants from micro-ITT who received at least 48 hours or <48 hours of study therapy before discontinuation due to AE, no concomitant antibiotics against baseline MBL positive pathogens between 1st dose and TOC (excluding those with failed study therapy requiring additional antibiotics), had baseline organisms confirmed by central microbiological testing (except when locally confirmed); no indeterminate clinical outcomes at TOC.

    Measured: Up to 24 hours after the last infusion on Day 14

  11. Percentage of Pathogens According to Favourable Per-Pathogen Microbiological Response at the TOC Visit-ME Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants). ME analysis set comprised of participants from micro-ITT who received at least 48 hours or <48 hours of study therapy before discontinuation due to AE, no concomitant antibiotics against baseline MBL positive pathogens between 1st dose and TOC (excluding those with failed study therapy requiring additional antibiotics), had baseline organisms confirmed by central microbiological testing (except when locally confirmed); no indeterminate clinical outcomes at TOC.

    Measured: Day 28

  12. Percentage of Participants Who Died Within 28 Days From Randomization-ITT Analysis Set

    Percentage of participants who died due to any cause on or before 28 days after randomization were reported in this outcome measure.

    Measured: From randomization up to Day 28

  13. Percentage of Participants Who Died Within 28 Days From Randomization- Micro ITT Analysis Set

    Percentage of participants who died due to any cause on or before 28 days after randomization were reported in this outcome measure.

    Measured: From randomization up to Day 28

  14. Number of Participants With Treatment Emergent Adverse Events and Serious Adverse Events

    An adverse event (AE) was any untoward medical occurrence in a study participant administered a product or medical device; the event need not necessarily have a causal relationship with the treatment or usage. A serious adverse event (SAE) was any untoward medical occurrence at any dose that: resulted in death; was life-threatening (immediate risk of death); required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/ incapacity; resulted in congenital anomaly/birth defect; considered an important medical event. Treatment-emergent adverse event (TEAE) was any AE that started after the study medication start date and time.

    Measured: From first dose of study treatment (Day 1) until late follow-up visit (Up to Day 45)

  15. Number of Participants With Vital Sign Abnormalities

    Vital signs included blood pressure and heart rate and were measured in a supine position after at least 10 minutes of rest for the participants. Criteria for vital sign abnormalities included: systolic blood pressure (SBP): value >150 millimeters of mercury (mmHg) and increase from baseline >=30 mmHg and value <90 and decrease from baseline ≥30. Diastolic BP (mm Hg) Value >100 and increase from baseline >= 20 and Value <50 and decrease from baseline >=20. Heart Rate (beats per minute [BPM]): Value <40 or >120.

    Measured: From first dose of study treatment (Day 1) until TOC (Up to Day 28)

  16. Number of Participants With Abnormal Physical Examination Findings

    Physical examination included assessment of the following: abdomen, cardiovascular, ears, eyes, general appearance, head, lungs, lymph nodes, musculoskeletal, neurological, nose, skin and throat. Number of participants with abnormal physical examination findings for each body system is reported in this outcome measure.

    Measured: Baseline (last non-missing value observed before start of treatment on Day 1), EOT (Up to 24 hours after the last infusion on Day 14), TOC (Day 28)

  17. Number of Participants With Clinically Significant Abnormalities in Hematology Assessments

    Potential clinically significant criteria included: Hematocrit <0.7*lower limit of normal (LLN) and >30% Decrease from Baseline or >1.3*upper limit of normal (ULN) and >30% Increase from Baseline; Hemoglobin: <0.7*LLN and >30% Decrease from Baseline and>1.3*ULN and >30% Increase from Baseline;;Erythrocytes: <0.7*LLN and >30% Decrease from Baseline or >1.3*ULN and >30% Increase from Baseline; Leukocytes: <0.65*LLN and >60% Decrease from Baseline or >1.5*ULN and >100% Increase from Baseline; Basophils/Leukocytes, Eosinophils/Leukocytes and Monocytes/Leukocytes: >4.0*ULN and>300% Increase from Baseline; Lymphocytes/Leukocytes <0.25*LLN and >75% Decrease from Baseline and >1.5* ULN and >100% Increase from Baseline; Neutrophils/Leukocytes: <0.65*LLN and >75% Decrease from Baseline or >1.6*ULN and >100% Increase from Baseline; Platelets<0.65*LLN and >50% Decrease from Baseline or >1.5*ULN and >100% Increase from Baseline.

    Measured: From first dose of study treatment (Day 1) until TOC (Up to Day 28)

  18. Number of Participants With Clinically Significant Abnormalities in Clinical Chemistry Assessments

    Criteria for potential clinically significant results were: Aspartate Aminotransferase and Alanine Aminotransferase: >3.0* ULN and >100% increase from baseline (IFB); Bilirubin: >1.5* ULN and >100% IFB; Direct Bilirubin: >2.0* ULN and >150% IFB; Alkaline Phosphatase: 80% decrease from baseline (DFB) and >3.0* ULN and >100% IFB; Urea Nitrogen:100% DFB and >3.0* ULN and >200% IFB; Creatinine >2.0* ULN and >100% IFB; Sodium :10% DFB or >1.1* ULN and >10% IFB; Potassium: 20% DFB or >1.2* ULN and >20% IFB; Chloride: 20% DFB or >1.2*ULN and >20% IFB; Bicarbonate: 40% DFB or >1.3* ULN and >40% IFB; Calcium: 30% DFB or >1.3* ULN and >30% IFB; Albumin: 50% DFB or >1.5* ULN and >50% IFB; Glucose: 40% DFB or >3.0*ULN and >200% IFB.

    Measured: From first dose of study treatment (Day 1) until TOC (Up to Day 28)

  19. Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG)

    A standard 12-lead ECG was recorded with the participant in a supine position after at least 10 minutes of rest. The following ECG parameters were recorded: heart rate, PR-interval, QRS-duration, QT-interval, QTc-interval, RR interval. Clinical significance of ECG abnormalities was judged by Investigator.

    Measured: From first dose of study treatment (Day 1) until TOC (Up to Day 28)

Timeline

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

  1. First posted9 Jul 2018
  2. Study start25 Dec 2020
  3. Primary completion23 Jan 2023
  4. Study completion23 Jan 2023

Why it stopped: Recruitment of patients with serious infections caused by gram-negative bacteria producing MBL has been challenging. Date study terminated: 16-Dec-2022.

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
15 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03580044
Sponsor's protocol ID
C3601009
Other IDs
2017-004544-38, ASSEMBLE, 2017
Status last verified
Jan 2024
First submitted
4 Jun 2018
Last updated
2 Feb 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.

Publications

  • Raber SR, Xie R, Rogers H, Soto E, Arhin FF, Stone GG, Leister-Tebbe H, Chow JW. Microbiological, Clinical, and Pharmacokinetic/Pharmacodynamic Data to Support EUCAST Aztreonam-Avibactam Minimum Inhibitory Concentration Susceptibility Breakpoints Against Enterobacterales. Infect Dis Ther. 2026 Jan;15(1):183-195. doi: 10.1007/s40121-025-01267-3. Epub 2025 Nov 21.

    PubMed 41269522

  • Xie R, Rogers H, Chow JW, Soto E, Raber SR. Population pharmacokinetic/pharmacodynamic modeling to optimize aztreonam-avibactam dose regimens for adult patients. Antimicrob Agents Chemother. 2025 Aug 6;69(8):e0195024. doi: 10.1128/aac.01950-24. Epub 2025 Jun 18.

    PubMed 40530972

  • Das S, Riccobene T, Carrothers TJ, Wright JG, MacPherson M, Cristinacce A, McFadyen L, Xie R, Luckey A, Raber S. Dose selection for aztreonam-avibactam, including adjustments for renal impairment, for Phase IIa and Phase III evaluation. Eur J Clin Pharmacol. 2024 Apr;80(4):529-543. doi: 10.1007/s00228-023-03609-x. Epub 2024 Jan 22.

    PubMed 38252170

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing ATM-AVI and BAT in people with Serious Bacterial Infection, run by Pfizer at 42 sites in 12 countries.

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 60 inclusion and 12 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: stopped early, as of the sponsor's last update on 2 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 42 sites in China, Greece, India, Romania, Philippines and 7 more countries. 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?

Yes. Results are posted in the registry (first posted 2 Feb 2024). 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?

Percentage of Participants With Clinical Cure at the Test of Cure (TOC) Visit -Microbiological Intent to Treat (Micro-ITT) Analysis Set (time frame: Day 28). 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 NCT03580044, which also lists 3 linked publications.

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 2 Feb 2024.

AzTrials uses cookies for analytics and advertising. You can accept or reject them; the site works either way. Privacy Policy.

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