CAPD-related PeritonitisNCT04367974
Clinical Pharmacokinetic Study of Ceftazidime and Cefazolin
An observational study of CAPD-related Peritonitis, run by Fifth Affiliated Hospital, Sun Yat-Sen University at 1 site in China.
Trial summary
Peritoneal dialysis-related peritonitis is a common complication of peritoneal dialysis, which is the main cause of transfer from peritoneal dialysis to hemodialysis. Guidelines for International Society for peritoneal dialysis（ISPD）published in 2016 recommend that timely and adequate use of antibiotics is the most… Read more about this study
- Who is it for?
- Ages 15 to 70 years
- Conditions the study is for
- CAPD-related Peritonitis
- How many people
- 20 participants
- Where
- 1 siteChina
- Study dates
- 1 Jun 2020to 1 May 2022
- Phase
- Observational
- 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 15 to 70 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: CAPD-related peritonitis patients who accord with the inclusion Criteria and without the exclusion Criteria.
Who may be able to join
- Maintained on continuous ambulatory PD (CAPD) for at least 1 month,all patients received 4 exchanges per day with dialysate volumes of 2 L per exchange.
- The diagnostic criteria for CAPD-related peritonitis are as follows:
- The dialysate fluid appears cloudy and accord with the following peritonitis diagnostic criteria: (with the following two can be diagnosed) A. Clinical manifestations of peritoneics, such as abdominal pain and/or turbid flow of fluid from peritoneal dialysis; B. Perital dialysis discharge of liquid pathogen culture positive. C. The white blood cell count of perital dialysis outflow liquid were more than 0. 1 x 10 x 9/L, and the percentage of polymorphic nucleocells is more than 50% (peritoneal dialysis fluid remains in the abdominal cavity for at least 2 hours for more than 2 hours);
- No urine (less than 100ml per 24h).
- Age range form 15 years old to 70 years old, gender is not limited;
- Understand and agree to this clinical trial study.
Who cannot join
- With a clear history of cephalosporine drug allergy or hypersensitivity;
- Received antibiotic treatment within 1 week prior to entering the study;
- Pregnant and lactating women;
- Sepsis;
- Patients with celiac malignancy;
- The patient is unable to cooperate or unwilling to accept the test.
Trial locations and contacts
1 site in 1 country.
China1 site
the fifth affiliated hospital of SUN YAT-SEN university
Zhuhai, Guangdong, 519000
About this study
Official title: Clinical Pharmacokinetic Study of Ceftazidime and Cefazolin in Treating CAPD-related Peritonitis
Peritoneal dialysis-related peritonitis is a common complication of peritoneal dialysis, which is the main cause of transfer from peritoneal dialysis to hemodialysis. Guidelines for International Society for peritoneal dialysis（ISPD）published in 2016 recommend that timely and adequate use of antibiotics is the most important part of treatment. Empiric treatment should be initiated as soon as possible after obtaining microbiological specimens，then adjust the antibiotics according to culture results and drug sensitivity of bacteria. Intraperitoneal antibiotic can ensure antibiotic concentrations at the local sites of the infection are maximized，however, in patients with renal failure, the investigators should pay attention to the nephrotoxicity caused by the reduction of renal excretion，being guided by Pharmacokinetic/ Pharmacodynamic Principle on antibiotic can develop dosing recommendations to optimize antibiotic efficacy and minimize toxicity. In this study, the investigators aim to detect the concentration of ceftazidime and cefazolin in CAPD patients，so as to analyze the pharmacokinetics parameters and evaluate the rationality of the treatment.
Read the detailed description
The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg，they were given intraperitoneal twice daily in the first bag and the fourth bag for 5 days，and given 1g once daily in the fourth bag for 9 days. Total treatment duration was 2 weeks.
At least 1-mL serum and 5-mL dialysate samples were collected at 1, 2, 4, 6, 10, 14 days after complete instillation of the first dialysis bag containing antibiotic into the peritoneal cavity. The samples were then centrifuged at 3,000 rpm, all study samples were stored frozen (-80℃) within 1 hour after collection.
- Conditions
- CAPD-related Peritonitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| 1 | The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg，they were given intraperitoneal twice daily in the first bag and the fourth bag for 5 days，and given 1g once daily in the fourth bag for 9 days. Total treatment duration was 2 weeks. | |
| 2 | The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg，and were given once daily in the fourth bag. Total treatment duration was 2 weeks. |
What is being measured
The primary outcome is the main question the study is designed to answer.
concentration of ceftazidime and cefazolin
Cefazolin and ceftazidime were measured by LC-MS. The lower limit of quantitation for cefazolin and ceftazidime was 0.05 -1.0 μg /ml.
Measured: 2 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Apr 2020
- Study start1 Jun 2020 (estimated)
- Primary completion1 May 2021 (estimated)
- Study completion1 May 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for CAPD-related PeritonitisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Prospective
- Enrolment
- 20 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Fifth Affiliated Hospital, Sun Yat-Sen University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04367974
- Sponsor's protocol ID
- WZhu
- Status last verified
- Apr 2020
- First submitted
- 26 Apr 2020
- Last updated
- 21 May 2020
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW. ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int. 2016 Sep 10;36(5):481-508. doi: 10.3747/pdi.2016.00078. Epub 2016 Jun 9. No abstract available.
PubMed 27282851Htay H, Cho Y, Pascoe EM, Hawley C, Clayton PA, Borlace M, Badve SV, Sud K, Boudville N, McDonald SP, Johnson DW. Outcomes of Acinetobacter Peritonitis in Peritoneal Dialysis Patients: A Multicenter Registry Analysis. Perit Dial Int. 2018 Jul-Aug;38(4):257-265. doi: 10.3747/pdi.2017.00199. Epub 2018 Feb 7.
PubMed 29437143Ranganathan D, Varghese JM, Fassett RG, Lipman J, D'Intini V, Healy H, Roberts JA. Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD) study. BMC Nephrol. 2009 Dec 16;10:42. doi: 10.1186/1471-2369-10-42.
PubMed 20003546Manley HJ, Bailie GR. Treatment of peritonitis in APD: pharmacokinetic principles. Semin Dial. 2002 Nov-Dec;15(6):418-21. doi: 10.1046/j.1525-139x.2002.00103.x.
PubMed 12437537McKinnon PS, Paladino JA, Schentag JJ. Evaluation of area under the inhibitory curve (AUIC) and time above the minimum inhibitory concentration (T>MIC) as predictors of outcome for cefepime and ceftazidime in serious bacterial infections. Int J Antimicrob Agents. 2008 Apr;31(4):345-51. doi: 10.1016/j.ijantimicag.2007.12.009. Epub 2008 Mar 4.
PubMed 18313273Cardone KE, Grabe DW, Zasowski EJ, Lodise TP. Reevaluation of ceftazidime dosing recommendations in patients on continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 2014;58(1):19-26. doi: 10.1128/AAC.00873-13. Epub 2013 Oct 14.
PubMed 24126585Tosukhowong T, Eiam-Ong S, Thamutok K, Wittayalertpanya S, Na Ayudhya DP. Pharmacokinetics of intraperitoneal cefazolin and gentamicin in empiric therapy of peritonitis in continuous ambulatory peritoneal dialysis patients. Perit Dial Int. 2001 Nov-Dec;21(6):587-94.
PubMed 11783768Booranalertpaisarn V, Eiam-Ong S, Wittayalertpanya S, Kanjanabutr T, Na Ayudhya DP. Pharmacokinetics of ceftazidime in CAPD-related peritonitis. Perit Dial Int. 2003 Nov-Dec;23(6):574-9.
PubMed 14703199Grabe DW, Bailie GR, Eisele G, Frye RF. Pharmacokinetics of intermittent intraperitoneal ceftazidime. Am J Kidney Dis. 1999 Jan;33(1):111-7. doi: 10.1016/s0272-6386(99)70265-9.
PubMed 9915275
Study at a glance
From the registry record, last updated by the sponsor on 21 May 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Pharmacokinetic Study of Ceftazidime and Cefazolin in Treating CAPD-related Peritonitis
- ClinicalTrials.gov ID
- NCT04367974
- Acronym / sponsor ID
- WZhu
- Conditions
- CAPD-related Peritonitis
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 20 participants (estimated)
- Lead sponsor
- Fifth Affiliated Hospital, Sun Yat-Sen UniversityUniversity, hospital or other
- Study start
- 1 Jun 2020 (estimated)
- Primary completion
- 1 May 2021 (estimated)
- Study completion
- 1 May 2022 (estimated)
- First posted
- 29 Apr 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Peritoneal dialysis-related peritonitis is a common complication of peritoneal dialysis, which is the main cause of transfer from peritoneal dialysis to hemodialysis. Guidelines for International Society for peritoneal dialysis（ISPD）published in 2016 recommend that timely and adequate use of antibiotics is the most important part of treatment. Empiric treatment should be initiated as soon as possible after obtaining microbiological specimens，then adjust the antibiotics according to culture results and drug sensitivity of bacteria. Intraperitoneal antibiotic can ensure antibiotic concentrations at the local sites of the infection are maximized，however, in patients with renal failure, the investigators should pay attention to the nephrotoxicity caused by the reduction of renal excretion，being guided by Pharmacokinetic/ Pharmacodynamic Principle on antibiotic can develop dosing recommendations to optimize antibiotic efficacy and minimize toxicity. In this study, the investigators aim to detect the concentration of ceftazidime and cefazolin in CAPD patients，so as to analyze the pharmacokinetics parameters and evaluate the rationality of the treatment.
Detailed description
The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg，they were given intraperitoneal twice daily in the first bag and the fourth bag for 5 days，and given 1g once daily in the fourth bag for 9 days. Total treatment duration was 2 weeks.
At least 1-mL serum and 5-mL dialysate samples were collected at 1, 2, 4, 6, 10, 14 days after complete instillation of the first dialysis bag containing antibiotic into the peritoneal cavity. The samples were then centrifuged at 3,000 rpm, all study samples were stored frozen (-80℃) within 1 hour after collection.
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 1 | – | –The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg，they were given intraperitoneal twice daily in the first bag and the fourth bag for 5 days，and given 1g once daily in the fourth bag for 9 days. Total treatment duration was 2 weeks. |
| 2 | – | –The dose of cefazolin and Ceftazidime co-administered were 20 mg /kg，and were given once daily in the fourth bag. Total treatment duration was 2 weeks. |
Who may qualify
- Ages
- 15 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- CAPD-related peritonitis patients who accord with the inclusion Criteria and without the exclusion Criteria.
Key inclusion criteria (6 listed)
- Maintained on continuous ambulatory PD (CAPD) for at least 1 month,all patients received 4 exchanges per day with dialysate volumes of 2 L per exchange.
- The diagnostic criteria for CAPD-related peritonitis are as follows:
- The dialysate fluid appears cloudy and accord with the following peritonitis diagnostic criteria: (with the following two can be diagnosed) A. Clinical manifestations of peritoneics, such as abdominal pain and/or turbid flow of fluid from peritoneal dialysis; B. Perital dialysis discharge of liquid pathogen culture positive. C. The white blood cell count of perital dialysis outflow liquid were more than 0. 1 x 10 x 9/L, and the percentage of polymorphic nucleocells is more than 50% (peritoneal dialysis fluid remains in the abdominal cavity for at least 2 hours for more than 2 hours);
- No urine (less than 100ml per 24h).
- Age range form 15 years old to 70 years old, gender is not limited;
Key exclusion criteria (6 listed)
- With a clear history of cephalosporine drug allergy or hypersensitivity;
- Received antibiotic treatment within 1 week prior to entering the study;
- Pregnant and lactating women;
- Sepsis;
- Patients with celiac malignancy;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
concentration of ceftazidime and cefazolin
Time frame: 2 weeks
Cefazolin and ceftazidime were measured by LC-MS. The lower limit of quantitation for cefazolin and ceftazidime was 0.05 -1.0 μg /ml.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 May 2020.
- Results publication: PubMed 27282851Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW. ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int. 2016 Sep 10;36(5):481-508. doi: 10.3747/pdi.2016.00078. Epub 2016 Jun 9. No abstract available.
- Results publication: PubMed 29437143Htay H, Cho Y, Pascoe EM, Hawley C, Clayton PA, Borlace M, Badve SV, Sud K, Boudville N, McDonald SP, Johnson DW. Outcomes of Acinetobacter Peritonitis in Peritoneal Dialysis Patients: A Multicenter Registry Analysis. Perit Dial Int. 2018 Jul-Aug;38(4):257-265. doi: 10.3747/pdi.2017.00199. Epub 2018 Feb 7.
- Results publication: PubMed 20003546Ranganathan D, Varghese JM, Fassett RG, Lipman J, D'Intini V, Healy H, Roberts JA. Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD) study. BMC Nephrol. 2009 Dec 16;10:42. doi: 10.1186/1471-2369-10-42.
- Results publication: PubMed 12437537Manley HJ, Bailie GR. Treatment of peritonitis in APD: pharmacokinetic principles. Semin Dial. 2002 Nov-Dec;15(6):418-21. doi: 10.1046/j.1525-139x.2002.00103.x.
- Results publication: PubMed 18313273McKinnon PS, Paladino JA, Schentag JJ. Evaluation of area under the inhibitory curve (AUIC) and time above the minimum inhibitory concentration (T>MIC) as predictors of outcome for cefepime and ceftazidime in serious bacterial infections. Int J Antimicrob Agents. 2008 Apr;31(4):345-51. doi: 10.1016/j.ijantimicag.2007.12.009. Epub 2008 Mar 4.
- Results publication: PubMed 24126585Cardone KE, Grabe DW, Zasowski EJ, Lodise TP. Reevaluation of ceftazidime dosing recommendations in patients on continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 2014;58(1):19-26. doi: 10.1128/AAC.00873-13. Epub 2013 Oct 14.
- Results publication: PubMed 11783768Tosukhowong T, Eiam-Ong S, Thamutok K, Wittayalertpanya S, Na Ayudhya DP. Pharmacokinetics of intraperitoneal cefazolin and gentamicin in empiric therapy of peritonitis in continuous ambulatory peritoneal dialysis patients. Perit Dial Int. 2001 Nov-Dec;21(6):587-94.
- Results publication: PubMed 14703199Booranalertpaisarn V, Eiam-Ong S, Wittayalertpanya S, Kanjanabutr T, Na Ayudhya DP. Pharmacokinetics of ceftazidime in CAPD-related peritonitis. Perit Dial Int. 2003 Nov-Dec;23(6):574-9.
- Results publication: PubMed 9915275Grabe DW, Bailie GR, Eisele G, Frye RF. Pharmacokinetics of intermittent intraperitoneal ceftazidime. Am J Kidney Dis. 1999 Jan;33(1):111-7. doi: 10.1016/s0272-6386(99)70265-9.
- Individual participant dataSharing planned: Undecided
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of CAPD-related Peritonitis, run by Fifth Affiliated Hospital, Sun Yat-Sen University at 1 site in China.
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 6 inclusion and 6 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: status not confirmed, as of the sponsor's last update on 21 May 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. 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.
Are results available for this study?
Results are not available in the source record.
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?
concentration of ceftazidime and cefazolin (time frame: 2 weeks). 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 NCT04367974, which also lists 9 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 21 May 2020.