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PregnancyNCT07207876

Study of Ceftriaxone and Benzathine Penicillin G During Pregnancy

An observational study of Pregnancy, run by International Maternal Pediatric Adolescent AIDS Clinical Trials Group at 9 sites in 2 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

IMPAACT 2044 is a study to characterize the pharmacokinetics (PK) and safety of ceftriaxone and benzathine penicillin G during pregnancy. Up to 78 pregnant women receiving (1) ceftriaxone for indications other than syphilis or (2) benzathine penicillin G for treatment of syphilis from non-study clinical care providers… Read more about this study

Who is it for?
Any age, women only
Conditions the study is for
Pregnancy
What is being tested?
Ceftriaxon and Benzathine penicillin G
Type of treatment
Injection or infusion
How many people
110 participants
Where
9 sitesin 2 countries
Study dates
16 Feb 2026to 30 Sep 2027
Phase
Observational
Are there results?
Not yet: the study is under way

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 Any age
  • Women only
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Women receiving or expecting to receive ceftriaxone for indications other than syphilis or benzathine penicillin G for treatment of syphilis during pregnancy in the United States (US). The infants of pregnant participants receiving benzathine penicillin G will also be enrolled.

Who may be able to join

  • Is of legal age or circumstance to provide independent informed consent as determined by site standard operating procedures (SOPs) and consistent with Institutional Review Board (IRB) policies and procedures and is willing and able to provide written informed consent for her own and, if applicable (Arm 2), her infant's study participation
  • At screening, has a viable singleton intrauterine pregnancy of any gestational age confirmed by fetal ultrasound, as determined by the site investigator based on medical records, with trimester documented based on the best available obstetric estimate
  • At screening, is receiving or expected to receive one of the following drugs under study as prescribed by a clinical care provider and documented in medical records:
  • Ceftriaxone: IV or IM administration for an indication other than syphilis
  • Benzathine penicillin G: IM administration for treatment of syphilis
  • At entry, expects to remain in the geographic area of the study site during pregnancy and at least 30 days postpartum

Who cannot join

  • Previously enrolled in this study
  • Requires desensitization to ceftriaxone or benzathine penicillin G as determined by the site investigator based on pregnant participant report and available medical records
  • Has any of the following as determined by the site investigator based on pregnant participant report and available medical records:
  • Current indication for hemodialysis
  • Current indication for intensive care unit hospitalization
  • Creatinine (Cr) ≥ 3.5 x upper limit of normal (ULN) at any time during the current pregnancy and/or chronic kidney disease Stage 5
Show all 28Show fewer
  • Receipt of any of the following prohibited medications within seven days prior to entry as determined by the site investigator based on pregnant participant report and available medical records:
  • Probenecid
  • Penicillin
  • Arm 1A: any penicillin
  • Arm 1B: any penicillin
  • Arm 2: penicillin other than benzathine penicillin G
  • Benzapril
  • Chlorpropamide
  • Diflunisal
  • Irbesartan
  • Ketoprofen
  • Ketorolac tromethamine
  • Meclofenamic acid
  • Mefenamic acid
  • Oxaprozin
  • Parecoxib
  • Penciclovir
  • Pioglitazone
  • Telmisartan
  • Valsartan
  • Receipt of any investigational agent within seven days prior to entry as determined by the site investigator based on pregnant participant report and available medical records
  • Has any documented or suspected clinically significant condition that, in the opinion of the site investigator, would make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving study objectives

Trial locations and contacts

9 sites in 2 countries. Contact the study team or a site near you to ask about taking part.

9 sites in 2 countries

United States8 sites, 8 recruiting
  • Site 5083, Rush Univ. Cook County Hosp. Chicago NICHD CRS

    Chicago, Illinois, 60612

    Miriam Aziz, 312-572-4265, mariam_aziz@rush.edu

    Not yet recruiting
  • Site 4001, Lurie Children's Hospital of Chicago (LCH) CRS

    Chicago, Illinois, 60614

    Jennifer Jao, 312-227-4080, JJao@luriechildrens.org

    Recruiting
  • Site 5128, Baylor College of Medicine/Texas Children's Hospital NICHD CRS

    Houston, Texas, 77030

    Mary Paul, 832-822-1038, mpaul@bcm.edu

    Recruiting
  • Site 5048, USC - Maternal Child Adolescent/Adult Center

    Los Angeles, California, 90033

    Alice Stek, 323-865-1585, stek@usc.edu

    Recruiting
  • Site 5112, David Geffen School of Medicine at UCLA NICHD CRS

    Los Angeles, California, 90095

    Jaime Deville, 310-825-9660, jdeville@mednet.ucla.edu

    Recruiting
  • Site 5040, SUNY Stony Brook NICHD CRS

    Stony Brook, New York, 11794

    Sharon Nachman, 631-444-7692, sharon.nachman@stonybrookmedicine.edu

    Recruiting
  • Site 5114, Bronx-Lebanon Hospital Center NICHD CRS

    The Bronx, New York, 10457

    Murli Purswani, 718-960-1010, mpurswan@bronxcare.org

    Recruiting
  • Site 5013, Jacobi Med. Ctr. Bronx NICHD CRS

    The Bronx, New York, 10461

    Andrew Wiznia, 718-918-4664, andrew.wiznia@einsteinmed.edu

    Recruiting

Other trials in United States

Puerto Rico1 site, 1 recruiting
  • Site 5129, IMPAACT/Gamma Project/UPR Pediatric HIV/AIDS Research CRS

    San Juan, 00935

    Irma Febo, 787-759-9595, irma.febo2@upr.edu

    Recruiting

Other trials in Puerto Rico

About this study

Official title: Phase IV Study of the Pharmacokinetics and Safety of Ceftriaxone and Benzathine Penicillin G During Pregnancy

IMPAACT 2044 is a study to characterize the pharmacokinetics (PK) and safety of ceftriaxone and benzathine penicillin G during pregnancy. Up to 78 pregnant women receiving (1) ceftriaxone for indications other than syphilis or (2) benzathine penicillin G for treatment of syphilis from non-study clinical care providers will be enrolled at study sites located in the United States. Approximately 22 infants of pregnant participants receiving benzathine penicillin G will also be enrolled.

Read the detailed description

IMPAACT 2044 is a Phase IV, multi-site, open-label, non-randomized, opportunistic study to characterize the pharmacokinetics (PK) and safety of ceftriaxone and benzathine penicillin G during pregnancy.

The study includes two arms, with Arm 1 subdivided by route of administration:

Arm 1A: Intravenous (IV) ceftriaxone Arm 1B: Intramuscular (IM) ceftriaxone Arm 2: IM benzathine penicillin G

Conditions
Pregnancy
Being tested
Ceftriaxon, Benzathine penicillin G
Keywords
Cefriaxone, Syphilis, Pregnancy, Benzathine Penicillin G
Medical subject headings
Syphilis

What participants receive

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

  • CeftriaxonDrug

    Ceftriaxone will not be provided as part of the study. Pregnant participants will receive these drugs as prescribed outside the study by their non-study clinical care provider

  • Benzathine penicillin GDrug

    Benzathine penicillin G will not be provided as part of the study. Pregnant participants will receive these drugs as prescribed outside the study by their non-study clinical care provider

Study groups in NCT07207876
Study groupRoleWhat they receive
Active comparator: Arm 1A: IV ceftriaxoneIntravenous ceftriaxone
Receives: Drug: Ceftriaxon
Active Comparator: Arm 1B: IM ceftriaxoneIntramuscular ceftriaxone
Receives: Drug: Ceftriaxon
Active Comparator: Arm 2: IM benzathine penicillin GIntramuscular benzathine penicillin G
Receives: Drug: Benzathine penicillin G

What is being measured

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

  1. Geometric mean area under the curve (AUC) during the dosing interval (AUC0-tau) in the first trimester trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  2. Geometric mean terminal elimination half-life (t1/2) in the first trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  3. Geometric mean trough concentration (Ctrough) in the first trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  4. Geometric mean AUC0-tau in the second trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  5. Geometric mean t1/2 in the second trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  6. Geometric mean Ctrough in the second trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  7. Geometric mean AUC0-tau in the third trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  8. Geometric mean t1/2 in the third trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  9. Geometric mean Ctrough in the third trimester

    Arm 1A

    Measured: First on-study dose through 24 hours

  10. Median maximum plasma concentration during the dose interval (Cmax) in the first trimester

    Arm 1B

    Measured: First on-study dose through up to 24 hours

  11. Median time to Cmax (Tmax) in the first trimester

    Arm 1B

    Measured: First on-study dose through up to 24 hours

  12. Median Cmax in the second trimester

    Arm 1B

    Measured: First on-study dose through up to 24 hours

  13. Median Tmax in the second trimester

    Arm 1B

    Measured: First on-study dose through up to 24 hours

  14. Median Cmax in the third trimester

    Arm 1B

    Measured: First on-study dose through up to 24 hours

  15. Median Tmax in the third trimester

    Arm 1B

    Measured: First on-study dose through up to 24 hours

  16. Geometric mean AUC at 7 days (AUC 0-7d) in the first trimester

    Arm 2

    Measured: First on-study dose through 7 days

  17. Geometric mean AUC at 14 days (AUC0-14d) in the first trimester

    Arm 2

    Measured: First on-study dose through 14 days

  18. Geometric mean plasma concentration at 2 hours (C2h) in the first trimester

    Arm 2

    Measured: 2 hours post-first on-study dose

  19. Geometric mean plasma concentration at 24 hours (C24h) in the first trimester

    Arm 2

    Measured: 24 hours post-first on-study dose

  20. Geometric mean plasma concentration at 4 days (C4d) in the first trimester

    Arm 2

    Measured: 4 days post-first on-study dose

  21. Geometric mean plasma concentration at 7 days (C7d) in the first trimester

    Arm 2

    Measured: 7 days post-first on-study dose

  22. Geometric mean plasma concentration at 14 days (C14d) in the first trimester

    Arm 2

    Measured: 14 days post-first on-study dose

  23. Geometric mean AUC0-7d in the second trimester

    Arm 2

    Measured: First on-study dose through 7 days

  24. Geometric mean AUC0-14d in the second trimester

    Arm 2

    Measured: First on-study dose through 14 days

  25. Geometric mean C2h in the second trimester

    Arm 2 (as defined above)

    Measured: 2 hours post-first on-study dose

  26. Geometric mean C24h in the second trimester

    Arm 2 (as defined above)

    Measured: 24 hours post-first on-study dose

  27. Geometric mean C4d in the second trimester

    Arm 2 (as defined above)

    Measured: 4 days post-first on-study dose

  28. Geometric mean C7d in the second trimester

    Arm 2 (as defined above)

    Measured: 7 days post-first on-study dose

  29. Geometric mean C14d in the second trimester

    Arm 2 (as defined above)

    Measured: 14 days post-first on-study dose

  30. Geometric mean AUC0-7d in the third trimester

    Arm 2

    Measured: First on-study dose through 7 days

  31. Geometric mean AUC0-14d in the third trimester

    Arm 2

    Measured: First on-study dose through 14 days

  32. Geometric mean C2h in the third trimester

    Arm 2 (as defined above)

    Measured: 2 hours post-first on-study dose

  33. Geometric mean C24h in the third trimester

    Arm 2 (as defined above)

    Measured: 24 hours post-first on-study dose

  34. Geometric mean C4d in the third trimester

    Arm 2 (as defined above)

    Measured: 4 days post-first on-study dose

  35. Geometric mean C7d in the third trimester

    Arm 2 (as defined above)

    Measured: 7 days post-first on-study dose

  36. Geometric mean C14d in the third trimester

    Arm 2 (as defined above)

    Measured: 14 days post-first on-study dose

Secondary outcomes (9)
  1. Proportion of participants with a maternal serious adverse event (SAE)

    Arm 1A and Arm 1B

    Measured: First on-study dose through 7 days

  2. Proportion of participants with a maternal SAE assessed as related to drug under study

    Arm 1A and Arm 1B

    Measured: First on-study dose through 7 days

  3. Proportion of participants with a maternal SAE

    Arm 2

    Measured: First on-study dose through up to 28 days

  4. Proportion of participants with a maternal SAE assessed as related to drug under study

    Arm 2

    Measured: First on-study dose through up to 28 days

  5. Proportion of participants with a spontaneous abortion or miscarriage (<20 weeks gestation)

    Arm 1A, Arm1B, and Arm 2

    Measured: At pregnancy outcome/delivery/birth

  6. Proportion of participants with a stillbirth (≥20 weeks gestation)

    Arm 1A, Arm1B, and Arm 2

    Measured: At pregnancy outcome/delivery/birth

  7. Proportion of participants with an infant small for gestational age (SGA; weight <10th percentile for gestational age, adjusted for sex)

    Arm 1A, Arm1B, and Arm 2

    Measured: At pregnancy outcome/delivery/birth

  8. Proportion of participants with a preterm birth (<37 weeks gestation)

    Arm 1A, Arm1B, and Arm 2

    Measured: At pregnancy outcome/delivery/birth

  9. Proportion of participants with an infant congenital anomaly consistent with the definition of defect provided by Metropolitan Atlanta Congenital Defects Program (MACDP)

    Arm 1A, Arm1B, and Arm 2

    Measured: At pregnancy outcome/delivery/birth

Timeline

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

  1. First posted6 Oct 2025
  2. Study start16 Feb 2026
  3. Primary completion15 Jan 2027 (estimated)
  4. Study completion30 Sep 2027 (estimated)

Resources

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
Cohort
Time perspective
Prospective
Enrolment
110 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07207876
Sponsor's protocol ID
IMPAACT 2044
Other IDs
UM1AI068632, UM1AI068616, UM1AI106716, HHSN275201800001I
Status last verified
Aug 2026
First submitted
19 Sep 2025
Last updated
6 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data that underlie results in the publication, after deidentification.

Questions about this trial

What is this clinical trial studying?

An observational study of Pregnancy, run by International Maternal Pediatric Adolescent AIDS Clinical Trials Group at 9 sites in 2 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 6 inclusion and 28 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: looking for participants now, as of the sponsor's last update on 6 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States, Puerto Rico. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Lisa Levy (2028848480, impaact.ctgov@fstrf.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Geometric mean area under the curve (AUC) during the dosing interval (AUC0-tau) in the first trimester trimester (time frame: First on-study dose through 24 hours). The study lists 36 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 6 Aug 2026.

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