AzTrials
AzTrials

BacteremiaPhase 3ASTARTÉNCT04478721

Temocillin vs Meropenem for the Targeted Treatment of Bacteraemia Resistant to Third Gen Cephalosporins

A Phase 3 study testing Temocillin and Meropenem in people with Bacteremia, run by Fundación Pública Andaluza para la gestión de la Investigación en Sevilla at 29 sites in Spain.

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

A Phase 3, Multicenter, Randomised, Controlled, Open-Label Study to demonstrate noninferiority of temocillin (unauthorized investigational medicinal product IMP in Spain, but authorized in Belgium and UK) vs a carbapenem antibiotic (meropenem) in adults with bacteraemia due to third-generation cephalosporin-resistant… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bacteremia
What is being tested?
Temocillin and Meropenem
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
334 participants
Where
29 sitesSpain
Study dates
15 Dec 2020to 26 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

  • Adult patients with monomicrobial bacteremia due to Enterobacteriaceae showing resistance to cefotaxime, ceftriaxone (MIC >2 mg/L) and/or ceftazidime (MIC >4 mg/L), and sensible to temocillin (MIC ≤8 mg/L, except in bacteremia only of urinary origin, for which the criterion is MIC ≤16 mg/L ) and meropenem (MIC ≤2 mg/L).
  • Patients with polymicrobial bacteremia caused by more than one Enterobacteriaceae species may also be included, provided at least one of them is resistant to third-generation cephalosporins, and both are susceptible to meropenem and temocillin.
  • Duration of intravenous treatment is planned to be at least 4 days from randomization, or 3 days if the empirical treatment prior to randomization was active.
  • The patient signed informed consent form.
  • Potentially fertile patients must have a negative pregnancy test.

Who cannot join

  • <18 years
  • Pregnancy
  • Breastfeeding
  • Terminal condition, with life expectancy of less than 30 days, or palliative care , such that no actions will be taken to control the source of infection if necessary. Patients receiving palliative care with a life expectancy greater than 30 days may be included if source control is not necessary or, if necessary, will be carried out.
  • Allergy to betalactams
  • Polymicrobial bacteraemia (except when the other microorganism is considered a contaminant, (e.g. coagulase-negative staphylococci or diphtheroids in a single blood culture, or in cases where more than one Enterobacteriaceae species is isolated, provided that at least one isolate is resistant to third-generation cephalosporins and both are susceptible to meropenem and temocillin).
Show all 11Show fewer
  • Infections typically needing prolonged >14 days of therapy (e.g., endocarditis, prosthetic joint infection, vascular graft infection, empyema, chronic prostatitis) or meningitis. Patients who initially do not have a confirmed diagnosis of these infections may be included; if the diagnosis is made subsequently, the patient may be kept in the trial at the discretion of the investigator, establishing the duration of treatment that he considers necessary.
  • Active empirical treatment> 96 hours after initial blood culture extraction
  • Delay in inclusion> 48 h
  • Recruited in another clinical trial with active treatment
  • Peritoneal dialysis or continuous hemofiltration

Trial locations and contacts

29 sites in 1 country.

29 sites in 1 country

Spain29 sites
  • Complejo Hospitalario Universitario La Coruña

    A Coruña, 15006

  • Hospital General Universitario de Alicante

    Alicante, 03010

  • Hospital Universitario Torrecárdenas

    Almería, 04009

  • Hospital Universitario de Cruces

    Barakaldo, Bizkaia, 48903

  • Hospital del Mar

    Barcelona, 08003

  • Hospital Sant Pau

    Barcelona, 08041

  • Hospital Universitario Reina Sofía

    Córdoba, 14004

  • Hospital Universitario Virgen de las Nieves

    Granada, 18014

  • Hospital Universitario Clínico San Cecilio

    Granada, 18016

  • Hospital Universitario Juan Ramón Jiménez

    Huelva, 21005

  • Hospital Universitario de Jerez de la Frontera

    Jerez de la Frontera, Cádiz, 11407

  • Complejo Hospitalario San Millán-San Pedro De La Rioja

    Logroño, La Rioja, 26560

  • Hospital Universitario Locus Augusti, Lugo

    Lugo, 27003

  • Hospital Universitario de la Princesa

    Madrid, 28006

  • Hospital General Universitario Gregorio Marañón

    Madrid, 28007

  • Hospital Universitario Ramón y Cajal

    Madrid, 28034

  • Hospital Regional de Málaga

    Málaga, 29010

  • Hospital Universitario Virgen de la Victoria

    Málaga, 29010

  • Hospital Clínico Universitario Virgen de la Arrixaca

    Murcia, 30120

  • Hospital Universitari Son Espases

    Palma, 07120

  • Complejo Hospitalario de Navarra

    Pamplona, Navarre, 31008

  • Hospital Universitario de Puerto Real

    Puerto Real, Cádiz, 11510

  • Hospital ParcTaulí

    Sabadell, Barcelona, 08208

  • Hospital Marqués de Valdecilla

    Santander, Cantabria, 39008

  • Hospital Universitario Virgen Macarena

    Seville, 41009

  • Hospital Universitario Virgen del Rocío

    Seville, 41013

  • Hospital Universitario Virgen de Valme

    Seville, 41014

  • Hospital Universitario Mútua Terrassa

    Terrassa, Barcelona, 08221

  • Complejo Hospitalario Universitario de Vigo

    Vigo, 36313

Other trials in Spain

About this study

Official title: Randomised Controlled Trial of Temocillin vs Meropenem for the Targeted Treatment of Bacteraemia Due to Enterobacteriaceae Showing Resistance to Third Generation Cephalosporins

A Phase 3, Multicenter, Randomised, Controlled, Open-Label Study to demonstrate noninferiority of temocillin (unauthorized investigational medicinal product IMP in Spain, but authorized in Belgium and UK) vs a carbapenem antibiotic (meropenem) in adults with bacteraemia due to third-generation cephalosporin-resistant Enterobacteriaceae.

The duration of treatment will be between 7 and 14 days. From the 5th day of intravenous treatment, the sequential oral treatment is permitted if the patient meets appropriate conditions.

Read the detailed description

The objective of the trial is to demonstrate the non-inferiority of temocillin (2g each 8 hours, intravenous) to carbapenems (meropenem 1g each 8 hours, intravenous) in terms of efficacy and safety in the targeted treatment of bacteraemia due to Enterobacteriaceae resistant to third-generation cephalosporins, and therefore provide evidence for the use of temocillin in these infections.

The duration of treatment will be between 7 and 14 days. From the 5th day of intravenous treatment, the sequential oral treatment is permitted if the patient meets appropriate conditions.

Conditions
Bacteremia
Being tested
Temocillin, Meropenem
Keywords
Bacteraemia, Enterobacteriaceae, Temocillin, Third-generation cephalosporin-resistant Enterobacteriaceae.
Medical subject headings
Bacteremia, Toxemia

What participants receive

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

  • TemocillinDrug

    The intervention of experimental arm will be Intravenous administration of temocillin.

  • MeropenemDrug

    The intervention of comparator arm will be intravenous administration of meropenem.

Study groups in NCT04478721
Study groupRoleWhat they receive
TemocillinExperimentalPatients enrolled in this arm, will receive 2g each 8 hours of intravenous temocillin.
Receives: Drug: Temocillin
MeropenemActive comparatorPatients enrolled in this arm, will receive 1g each 8 hours of intravenous meropenem.
Receives: Drug: Meropenem

What is being measured

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

  1. Number of participants with a "success" at the test of cure (TOC)

    A success at the test of cure is the resolution of infection symptoms

    Measured: Up to 7-10 days after the last day of antibiotic therapy

  2. Survival at day 28

    Number of patients who are alive

    Measured: At day 28.

  3. Number of patients who do not need to stop or change the assigned drug

    Reasons for not change can be no adverse event, no perceived failure during treatment or no occurrence of a superimposed infection.

    Participants who stop or change the assigned drug will not meet the primary outcome.

    Measured: Up to 7-14 days after the last day of antibiotic therapy

  4. Number of patients who do not need to prolong therapy beyond 14 days

    Assigned treatment to be administered for less than 14 days

    Measured: Up to 7-14 days after the last day of antibiotic therapy

  5. Not recurrence until day 28

    Recurrence is reappearance of symptoms with positive blood culture for the same microorganism.

    Participants with recurrence will not meet the primary outcome.

    Measured: At day 28.

Secondary outcomes (10)
  1. 28-day mortality

    Number of patients dead up to day 28.

    Measured: Up to day 28.

  2. Length of hospital stay (days)

    Number of days patients has been in-hospital

    Measured: Through study completion, an average of 28 days

  3. Length of intravenous therapy (days)

    Number of days patients has been under intravenous antibiotic treatment

    Measured: From day 1 of intravenous antibiotic treatment administration to last intravenous administration, average 14 days

  4. Length of total administration of therapy (days)

    Number of days patients has been under intravenous or oral antibiotic treatment

    Measured: From day 1 of intravenous or oral antibiotic treatment administration to last intravenous or oral administration, average 14 days

  5. Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

    Measured: Up to day 28

  6. Number of subjects with resistance development during therapy

    Resistance development will be measured in a positive blood culture

    Measured: Up to day 28

  7. Recurrence rate

    Percentage of subjects with recurrence

    Measured: Up to day 28.

  8. Changes in Sequential Organ failure (SOFA) score

    Sequential Organ failure (SOFA) score changes

    Measured: At days 1, 3, end of treatment (days 7-14) and visit 4

  9. Changes in Barthel Index for Activities of Daily Living (ADL) for patients older than 70 years old

    Barthel Index for Activities of Daily Living (ADL) score changes; score from 0, completely dependent patient to 100, completely independent for activities of daily living

    Measured: At days 1, 3, end of treatment (days 7-14) and visit 4

  10. Number of subjects with development of superimposed infections.

    Development of superimposed infections will be measured in a positive culture

    Measured: 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 posted21 Jul 2020
  2. Study start15 Dec 2020
  3. Primary completion26 Dec 2024
  4. Study completion26 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
Model description
Randomized 1.1 to temocillin: meropenem
Masking
None (open label)
Enrolment
334 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04478721
Sponsor's protocol ID
ASTARTÉ
Other IDs
2020-000064-39
Acronym
ASTARTÉ
Status last verified
Jan 2026
First submitted
23 Mar 2020
Last updated
23 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Planning for the study will be shared with potential sites pertaining to Spanish Network for Research in Infectious Disease (REIPI)for participation. IPD is not foreseen out of this groups due to the specific characteristics of patients and sites to be candidates for study participation.

Publications

  • Dezza FC, Pulido LB, Borreguero IB, Perez FD, Jimenez VP, de la Rosa Riestra S, Bravo-Ferrer JM, Palacios-Baena ZR, Zuniga MAL, Cobo F, Gomez-Junyent J, Horcajada JP, Merino E, Parra M, Lopez-Contreras J, Rivera A, Regueiro DS, Garcia MP, Cardenas SL, Sanchez MCG, Camacho IP, Ramos SMM, Jimenez EL, Garcia AIA, Perez-Rodriguez MT, Sousa A, Ruiz MS, de Las Revillas Almajano FA, Perez LG, Agirre JG, Cano A, Martinez-Marcos FJ, Pais MJG, Sanchez RE, de la Villa S, Ara JRY, Esteban-Moreno MA, Ruiz-Sancho A, Aragon MP, Fernandez JA, Blandino AMB, Vilchez-Rueda HH, Alvarez-Marin R, Palacios AR, Vazquez EG, Alvarez EN, Rosso-Fernandez C, Gutierrez-Gutierrez B, Pascual A, Lopez-Cerero L, Rodriguez-Bano J; ASTARTE-GEIRAS study group. Temocillin versus carbapenems for bacteraemia due to third-generation cephalosporin-resistant Enterobacterales in Spain (ASTARTE): a multicentre, phase 3, open-label, non-inferiority, randomised clinical trial. Lancet. 2026 Aug 1;408(10553):430-439. doi: 10.1016/S0140-6736(26)00760-9. Epub 2026 Jul 9.

    PubMed 42425122
  • Marin-Candon A, Rosso-Fernandez CM, Bustos de Godoy N, Lopez-Cerero L, Gutierrez-Gutierrez B, Lopez-Cortes LE, Barrera Pulido L, Borreguero Borreguero I, Leon MJ, Merino V, Camean-Fernandez M, Retamar P, Salamanca E, Pascual A, Rodriguez-Bano J; ASTARTE Study Group. Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant Enterobacterales (ASTARTE): protocol for a randomised, pragmatic trial. BMJ Open. 2021 Sep 27;11(9):e049481. doi: 10.1136/bmjopen-2021-049481.

    PubMed 34580096

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Temocillin and Meropenem in people with Bacteremia, run by Fundación Pública Andaluza para la gestión de la Investigación en Sevilla at 29 sites in Spain.

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 5 inclusion and 11 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 23 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in Spain. 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?

Number of participants with a "success" at the test of cure (TOC) (time frame: Up to 7-10 days after the last day of antibiotic therapy). The study lists 5 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 NCT04478721, which also lists 2 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 23 Jan 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