Phase 2
N=1,310
Uncomplicated Skin and Soft Tissue Infections Caused by Community-Associated Methicillin-Resistant Staphylococcus Aureus
Staphylococcal Infection
Bottom Line
View on ClinicalTrials.gov: NCT00730028 ↗Enrolled (actual)
1,310
Serious AEs
1.3%
Results posted
Mar 2016
Primary outcome: Primary: Percentage of Participants Achieving Clinical Cure, Defined as Absence of Clinical Failure, in the Evaluable Population. — 89.5; 88.2; 92.9; 92.7 percentage of participants — p=0.7688
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Trimethoprim-sulfamethoxazole (Drug); Placebo (Other); Clindamycin (Drug)
- Age
- Pediatric, Adult, Older Adult · 0+ yrs
- Sex
- All
- Sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)
- Primary completion
- Feb 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants Achieving Clinical Cure, Defined as Absence of Clinical Failure, in the Evaluable Population. |
89.5; 88.2; 92.9; 92.7; 80.5 | 0.7688 |
| PRIMARY Percentage of Participants Achieving Clinical Cure, Defined as Absence of Clinical Failure, in the Intent-to-Treat (ITT) Population. |
80.3; 77.7; 83.1; 81.7; 68.9 | 0.5200 |
| SECONDARY Number of Participants Reporting Adverse Events. |
116; 132; 119; 94; 119 | — |
| SECONDARY Number of Participants Reporting Adverse Events That Are Treatment Limiting. |
1; 0; 6; 3; 4 | — |
| SECONDARY Percentage of Participants Achieving Clinical Cure at the End of Treatment (EOT) Visit for the Evaluable Population. |
89.2; 88.3; 90.9; 94.2; 84.9 | 0.7707 |
| SECONDARY Percentage of Participants Achieving Clinical Cure at the End of Treatment (EOT) Visit for the Intent-to-Treat (ITT) Population. |
81.1; 75.4; 78.9; 79.8; 72.4 | 0.1381 |
| SECONDARY Percentage of Participants Achieving Clinical Cure at the One Month Follow-up (OMFU) Visit for the Evaluable Population. |
83.9; 78.2; 89.3; 85.0; 73.9 | 0.1505 |
| SECONDARY Percentage of Participants Achieving Clinical Cure at the One Month Follow-up (OMFU) Visit for the Intent-to-Treat (ITT) Population. |
73.1; 67.7; 78.6; 73.0; 62.6 | 0.1815 |
Summary
The purpose of this clinical trial is to evaluate 2 different antibiotics, drugs that fight bacteria, [clindamycin (CLINDA) and trimethoprim-sulfamethoxazole (TMP-SMX)] and wound care for the outpatient management of uncomplicated skin and soft tissue infections (uSSTIs) in children and adults. The study will occur in areas where community associated methicillin-resistant Staphylococcus (S.) aureus are common. S. aureus is a type of bacteria. A total of 1310 volunteers, greater than or equal to 6 months of age and adults 85 years or younger, non-immunocompromised, with uSSTIs (in particular abscess and/or cellulitis) will be enrolled in this study. Subjects will be treated with one of the following: CLINDA, TMP-SMX, or placebo (contains no medication). Volunteers will be grouped based on the presence of cellulitis or abscess, whether the abscess can be surgically drained, and its size. The subject participation duration for this study is about 6 weeks.
Eligibility Criteria
Inclusion Criteria
- Age 6 months to 85 years.
- Able to complete the informed consent process or, if a minor, a parent or guardian who is able to complete the informed consent process; an assent form also will be completed for children age 7 and older.
- Willing and able to complete the study protocol, study-related activities, and visits.
- Diagnosis of uncomplicated skin and soft tissue infection (uSSTI), either cellulitis (defined as an inflammation of skin and associated skin structures) or abscess (defined as a circumscribed collection of pus), evidenced by at least 2 of the following localized signs or symptoms on the skin for at least 24 hours:
- Erythema
- Swelling or induration
- Local warmth
- Purulent drainage
- Tenderness to palpation or pain
- Able to take oral antibiotic therapy, either in pill or suspension form.
Exclusion Criteria
- Hospital in-patient.
- Hospitalization within the prior 14 days.
- Residence in a long-term skilled nursing facility.
- Requirement for hospitalization for skin infection or other condition.
- Previous enrollment in this protocol.
- Participation in another clinical trial within the previous 30 days.
- Superficial skin infection only, including:
- Impetigo
- Ecthyma
- Folliculitis
- Infections that have a high cure rate after surgical incision alone (such as isolated furunculosis) or after topical or local measures
- Unstable psychiatric or psychological condition rendering the subject unlikely to be cooperative or to complete study requirements.
- Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with the adherence or subject compliance with study requirements.
- Systolic blood pressure > 180 mm Hg.
- Systolic blood pressure (SBP) less than an age-specific critical value:
- Age 6 - 11 months: 140 BPM
- Age 1 to 8 years: > 120 BPM
- Age 9 to 17 years: > 120 BPM
- Age greater than or equal to 18 years: > 120 BPM.
- Oral temperature (or equivalent rectal, tympanic membrane, axillary) less than 35.5 degrees Celsius (95.9 degrees Fahrenheit).
- Oral temperature (or equivalent rectal, tympanic membrane, axillary) greater than age-specific critical value:
- Age 6 - 11 months: > 38.0 degrees Celsius (100.4 degrees Fahrenheit)
- Age 1 to 8 years: > 38.5 degrees Celsius (101.3 degrees Fahrenheit)
- Age 9 to 17 years: > 38.5 degrees Celsius (101.3 degrees Fahrenheit)
- Age greater than or equal to 18 years: > 38.5 degrees Celsius (101.3 degrees Fahrenheit).
- Documented human or witnessed animal bite in the past 30 days at the site of infection.
- Systemic antibacterial therapy with antistaphylococcal activity within the prior 14 days.
- The following concomitant medications: warfarin, phenytoin, methotrexate, rosiglitazone or sulfonylureas and systemically administered antibacterial agents with activity against staphylococci.
- Diagnosed or suspected disseminated or severe Staphylococcus aureus or group A streptococcal (GAS) infection, including lymphangitic spread of skin infection, septicemia, bacteremia, pneumonia, endocarditis, osteomyelitis, septic arthritis, gangrene, necrotizing fasciitis, myositis, or other serious infections.
- Infection at an anatomical skin site requiring specialized management or specialized antimicrobial therapy, including:
- Periauricular or orbital infection
- Perirectal infection
- Suspected deep space infection of the hand or foot
- Genital infection
- Mastitis
- Bursitis
- Radiographic evidence or suspicion of gas in the tissue or foreign body infection (note: radiography is not required for screening and can be performed at the discretion of the treating physician).
- Gastrointestinal symptoms such as nausea, vomiting, or diarrhea of a severity that would preclude consumption of oral antibiotics.
- Hypersensitivity or history of allergic reaction to study drug.
- History of glucose-6-phosphate dehydrogenase (G6PD) deficiency.
- Third trimester pregnancy: pregnant women
Data sourced from ClinicalTrials.gov (NCT00730028). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.