Clinical trial

BonE and Joint Infections - Simplifying Treatment in Children Trial

Name
2019.287
Description
This is a multi- centre trial of children with bone and joint infections (BJIs) at eight major paediatric hospitals in Australia and New Zealand. The primary objective is to establish if in children with acute, uncomplicated BJIs, entirely oral antibiotic treatment is not inferior to initial intravenous (IV) treatment for 1 to 7 days followed by an oral antibiotic course in achieving full recovery 3 months after presentation. Children will be randomly allocated to the 'entirely oral antibiotic' group or the 'standard treatment' group.
Trial arms
Trial start
2021-06-01
Estimated PCD
2026-12-01
Trial end
2026-12-01
Status
Recruiting
Phase
Early phase I
Treatment
Oral cefalexin only
High-dose oral cefalexin
Arms:
Intervention
IV cefazolin or IV flucloxacillin followed by oral cefalexin
Standard therapy of IV cefazolin or IV flucloxacillin followed by high dose oral cefalexin
Arms:
Standard Therapy
Size
285
Primary endpoint
Proportion of children assessed as having made a full recovery 3 months
3 months
Eligibility criteria
Inclusion Criteria: * Children aged 1 to 18 years with acute, uncomplicated, community-acquired bone and joint infection who fulfil pre-defined clinical criteria. Exclusion Criteria: 1. Infection due to bacteria resistant to cefalexin or atypical infection (e.g. mycobacterial, fungal) 2. Features of sepsis as defined by the presence of organ dysfunction (defined using definitions within the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score) 3. Concomitant severe, invasive infection e.g. necrosing fasciitis 4. Complicated infection (e.g. presence of prosthetic material; large subperiosteal (\>3mm) or soft tissue abscess without surgical intervention; infection secondary to or complicated by trauma) 5. History of allergy to cephalosporin antibiotics or immediate, severe reaction to penicillins 6. Received more than three IV or oral dose of an antibiotic with activity against the likely bacteria causing the current infection 7. Prior episode of OM or SA 8. Prior condition predisposing to poor absorption (e.g. inflammatory bowel disease, current gastrointestinal symptoms) or complicated disease (e.g. immunodeficiency) 9. Prior enrolment in the trial 10. Current recipient of another investigational product as part of a clinical trial
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE4'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 285, 'type': 'ESTIMATED'}}
Updated at
2023-08-09

1 organization

2 products

4 indications

Product
Cefalexin
Indication
Bone Infection
Indication
Arthritis
Indication
Osteomyelitis