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Short Bowel SyndromePhase 1GRAALNCT05302531

Absorption of Antibiotics With High Oral Bioavailability in Short-bowel Syndrome

A Phase 1 study testing Amoxicillin, Levofloxacin and Ofloxacin in people with Short Bowel Syndrome and Infection, Bacterial, run by Central Hospital, Nancy, France at 1 site in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to assess the drug absorption of oral antibiotics in patients with short bowel syndrome. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Short Bowel Syndrome, Infection, Bacterial
What is being tested?
Amoxicillin, Levofloxacin and Ofloxacin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteFrance
Study dates
9 Dec 2022to Feb 2025
Phase
Phase 1
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

  • Short bowel syndrome
  • Treated for a documented infection with antibiogram by amoxicillin (+/- clavulanic acid)or ofloxacin or levofloxacin or sulfamethoxazole/trimethoprim
  • Hospitalized in the Nutritional Assistant Unit or the Infectiology Unit of the Regional University Hospital of Nancy
  • Affiliated to a social security system
  • Having received an physical examination before entering study
  • Having received full information regarding the study organization and having signed the informed consent

Who cannot join

  • Patient at risk of worsening their oral absorption abilities during study
  • Patient requiring dialysis
  • Women of childbearing age without efficient birth control
  • Allergy to any of the drugs tested
  • Person concerned by Articles L. 1121-5, L. 1121-7 et L1121-8 of the Code of public health
  • Person deprived of liberty or person undergoing psychiatric care pursuant to articles L. 3212-1 et L. 3213-1

Trial locations and contacts

1 site in 1 country.

Niasha MICHOT, MD contact

+33383155108

n.michot@chru-nancy.fr

Elise Pape contact

e.pape@chru-nancy.fr

France1 site, 1 recruiting
  • CHRU Nancy

    Vandœuvre-lès-Nancy, Lorraine, 54500

    Niasha MICHOT, MD, +33383155108, n.michot@chru-nancy.fr

    Julie LECOMTE, +33383155278, ju.lecomte@chru-nancy.fr

    Recruiting

Other trials in France

About this study

Official title: Absorption of Antibiotics With High Oral Bioavailability in Short-bowel Syndrome : a Monocentric Pilot Study

The purpose of this study is to assess the drug absorption of oral antibiotics in patients with short bowel syndrome.

Read the detailed description

When required, due to an infection, patients with short bowel syndrome will be treated with an intravenous antibiotic. The pharmacokinetic profile of that intravenous antibiotic will be determined. Once the full treatment with the intravenous antibiotic is over, the patient will be orally administered the same antibiotic, with determination of the oral pharmacokinetic profile, and both profiles will be compared, assessing the bioavailability of the oral antibiotic.

Being tested
Amoxicillin, Levofloxacin, Ofloxacin, Sulfamethoxazole trimethoprim
Medical subject headings
Short Bowel Syndrome, Bacterial Infections

What participants receive

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

  • AmoxicillinDrug

    Each patient will receive the proper antibiotic to treat the infection, first intravenously, then orally

  • LevofloxacinDrug

    Each patient will receive the proper antibiotic to treat the infection, first intravenously, then orally

  • OfloxacinDrug

    Each patient will receive the proper antibiotic to treat the infection, first intravenously, then orally

  • Sulfamethoxazole trimethoprimDrug

    Each patient will receive the proper antibiotic to treat the infection, first intravenously, then orally

Study groups in NCT05302531
Study groupRoleWhat they receive
AmoxicillinExperimentalEach patient will receive the IV antibiotic required to treat the infection, and after the proper duration of the IV antibiotic is over, the patient will receive a few days of the oral version of the same antibiotic.
Receives: Drug: Amoxicillin
OfloxacinExperimentalEach patient will receive the IV antibiotic required to treat the infection, and after the proper duration of the IV antibiotic is over, the patient will receive a few days of the oral version of the same antibiotic.
Receives: Drug: Ofloxacin
LevofloxacinExperimentalEach patient will receive the IV antibiotic required to treat the infection, and after the proper duration of the IV antibiotic is over, the patient will receive a few days of the oral version of the same antibiotic.
Receives: Drug: Levofloxacin
Sulfamethoxazole trimethoprimExperimentalEach patient will receive the IV antibiotic required to treat the infection, and after the proper duration of the IV antibiotic is over, the patient will receive a few days of the oral version of the same antibiotic.
Receives: Drug: Sulfamethoxazole trimethoprim

What is being measured

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

  1. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time -0.5 hours

  2. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +0.5 hours

  3. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +1 hour

  4. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +1.5 hour

  5. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +2 hours

  6. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +4 hours

  7. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +6 hours

  8. Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome

    F (%)=(ASC PO)/(ASC IV) x (Dose IV)/(Dose PO)

    Measured: Time +8 hours

Secondary outcomes (4)
  1. Describe antibiotic absorption after oral administration in these patients

    Peak plasma concentration (Cmax) after oral intake

    Measured: Time -0.5hour ; Time +0.5hour ; Time +1 hour ; Time+1.5 hour ; Time +2 hours ; Time+4 hours ; Time +6 hours ; Time + 8 hours

  2. Describe antibiotic absorption after oral administration in these patients

    Peak plasma concentration time after oral intake (Tmax)

    Measured: Time -0.5hour ; Time +0.5hour ; Time +1 hour ; Time+1.5 hour ; Time +2 hours ; Time+4 hours ; Time +6 hours ; Time + 8 hours

  3. Describe antibiotic absorption after oral administration in these patients

    Area under the plasma concentration versus time curve (AUC)

    Measured: Time -0.5hour ; Time +0.5hour ; Time +1 hour ; Time+1.5 hour ; Time +2 hours ; Time+4 hours ; Time +6 hours ; Time + 8 hours

  4. Assess link between length of remaining bowel and antibiotic absorption

    Length of remaining bowel (cm)

    Measured: At inclusion

Timeline

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

  1. First posted31 Mar 2022
  2. Study start9 Dec 2022
  3. Primary completionDec 2024 (estimated)
  4. Study completionFeb 2025 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05302531
Sponsor's protocol ID
2021-001468-13
Acronym
GRAAL
Status last verified
Aug 2024
First submitted
2 Mar 2022
Last updated
29 Aug 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Depending on first results, this pilot study might be extended in a new multicenter study

Publications

  • Scala-Bertola J, Rabiskova M, Lecompte T, Bonneaux F, Maincent P. Granules in the improvement of oral heparin bioavailability. Int J Pharm. 2009 Jun 5;374(1-2):12-6. doi: 10.1016/j.ijpharm.2009.02.020. Epub 2009 Mar 9.

    PubMed 19446753
  • American Gastroenterological Association. American Gastroenterological Association medical position statement: short bowel syndrome and intestinal transplantation. Gastroenterology. 2003 Apr;124(4):1105-10. doi: 10.1053/gast.2003.50139. No abstract available.

    PubMed 12671903
  • Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, Joly F, Kelly D, Lal S, Staun M, Szczepanek K, Van Gossum A, Wanten G, Schneider SM; Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of ESPEN. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr. 2016 Apr;35(2):247-307. doi: 10.1016/j.clnu.2016.01.020. Epub 2016 Feb 8.

    PubMed 26944585
  • Gupta A, Mehta Y, Juneja R, Trehan N. The effect of cannula material on the incidence of peripheral venous thrombophlebitis. Anaesthesia. 2007 Nov;62(11):1139-42. doi: 10.1111/j.1365-2044.2007.05180.x.

    PubMed 17924895
  • Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006 Sep;81(9):1159-71. doi: 10.4065/81.9.1159.

    PubMed 16970212
  • Ward N. The impact of intestinal failure on oral drug absorption: a review. J Gastrointest Surg. 2010 Jun;14(6):1045-51. doi: 10.1007/s11605-009-1151-9. Epub 2010 Jan 22.

    PubMed 20094812
  • Vance-Bryan K, Guay DR, Rotschafer JC. Clinical pharmacokinetics of ciprofloxacin. Clin Pharmacokinet. 1990 Dec;19(6):434-61. doi: 10.2165/00003088-199019060-00003.

    PubMed 2292168
  • Lamp KC, Bailey EM, Rybak MJ. Ofloxacin clinical pharmacokinetics. Clin Pharmacokinet. 1992 Jan;22(1):32-46. doi: 10.2165/00003088-199222010-00004.

    PubMed 1559306
  • Barr WH, Zola EM, Candler EL, Hwang SM, Tendolkar AV, Shamburek R, Parker B, Hilty MD. Differential absorption of amoxicillin from the human small and large intestine. Clin Pharmacol Ther. 1994 Sep;56(3):279-85. doi: 10.1038/clpt.1994.138.

    PubMed 7924123
  • Severijnen R, Bayat N, Bakker H, Tolboom J, Bongaerts G. Enteral drug absorption in patients with short small bowel : a review. Clin Pharmacokinet. 2004;43(14):951-62. doi: 10.2165/00003088-200443140-00001.

    PubMed 15530127
  • Cheung YW, Barco S, Mathot RAA, van den Dool EJ, Stroobants AK, Serlie MJ, Middeldorp S, Coppens M. Pharmacokinetics of dabigatran etexilate and rivaroxaban in patients with short bowel syndrome requiring parenteral nutrition: The PDER PAN study. Thromb Res. 2017 Dec;160:76-82. doi: 10.1016/j.thromres.2017.10.025. Epub 2017 Nov 4.

    PubMed 29127863
  • Faye E, Drouet L, De Raucourt E, Green A, Bal-Dit-Sollier C, Boudaoud L, Corcos O, Bergmann JF, Joly F, Lloret-Linares C. Absorption and efficacy of acetylsalicylic acid in patients with short bowel syndrome. Ann Pharmacother. 2014 Jun;48(6):705-10. doi: 10.1177/1060028014526700. Epub 2014 Mar 25.

    PubMed 24667978
  • Thielke J, Martin J, Weber FL, Schroeder TJ, Goretsky S, Hanto DW. Pharmacokinetics of tacrolimus and cyclosporine in short-bowel syndrome. Liver Transpl Surg. 1998 Sep;4(5):432-4. doi: 10.1002/lt.500040502. No abstract available.

    PubMed 9724482
  • Ueno T, Tanaka A, Hamanaka Y, Suzuki T. Serum drug concentrations after oral administration of paracetamol to patients with surgical resection of the gastrointestinal tract. Br J Clin Pharmacol. 1995 Mar;39(3):330-2. doi: 10.1111/j.1365-2125.1995.tb04457.x.

    PubMed 7619677
  • Menardi G, Guggenbichler JP. Bioavailability of oral antibiotics in children with short-bowel syndrome. J Pediatr Surg. 1984 Feb;19(1):84-6. doi: 10.1016/s0022-3468(84)80023-8.

    PubMed 6699766

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Amoxicillin, Levofloxacin and Ofloxacin in people with Short Bowel Syndrome and Infection, Bacterial, run by Central Hospital, Nancy, France at 1 site 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 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 29 Aug 2024. 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 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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

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?

Contact Niasha MICHOT, MD (+33383155108, n.michot@chru-nancy.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Assess the bioavailability of the oral antibiotic in patient with short bowel syndrome (time frame: Time -0.5 hours). The study lists 8 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 NCT05302531, which also lists 15 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 29 Aug 2024.

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GRAAL Clinical Trial NCT05302531 | AzTrials