Prevention of Arrhythmia Device Infection Trial (PADIT)
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Purpose
The goal of the study is to compare whether a center-wide policy of incremental antibiotic therapy will reduce infection compared to a policy of conventional antibiotic prophylaxis in high-risk patients undergoing arrhythmia device procedures. All antibiotics used are approved for use and readily available.
| Condition | Intervention | Phase |
|---|---|---|
|
Arrhythmia |
Drug: Incremental Drug: Conventional |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Prevention of Arrhythmia Device Infection Trial (PADIT) Cluster Crossover Study |
- Hospitalization attributed to device infection [ Time Frame: Evaluation is one year post patient's procedure ] [ Designated as safety issue: No ]
- 1. Proven device infection not requiring surgical intervention (medically treated device infection). [ Time Frame: Up to one year post procedure ] [ Designated as safety issue: No ]
- 2. Any treatment with antibiotics for suspected device infection. [ Time Frame: Up to one year post procedure ] [ Designated as safety issue: No ]
- 3. Antibiotic-related adverse events including culture or antigen proven C. difficile infection. [ Time Frame: Up to one year post procedure ] [ Designated as safety issue: No ]
- 4. Prolongation of hospitalization due to proven or suspected adverse events from the antibiotic therapy. [ Time Frame: Up to one year post procedure ] [ Designated as safety issue: No ]
- Cost benefit analysis [ Time Frame: At completion of data collection period ] [ Designated as safety issue: No ]
- 6. Rate of device/lead extraction 12 months post patient's procedure (regardless of the cause). [ Time Frame: Up to one year post procedure ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 10800 |
| Study Start Date: | December 2012 |
| Estimated Study Completion Date: | December 2015 |
| Estimated Primary Completion Date: | December 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Conventional
Preoperative Antibiotics
|
Drug: Conventional
Cefazolin preoperative
Other Name: Cefazolin
|
|
Experimental: Incremental
Preoperative antibiotics, antibiotic wash and post operative antibiotics
|
Drug: Incremental
Single dose of Cefazolin and Vancomycin preoperatively, bacitracin wash and cefalexin post operative.
Other Names:
|
Detailed Description:
This is a randomized prospective cluster crossover trial to track outcomes of high infection risk patients undergoing arrhythmia device procedures. Centres will be randomized to either conventional antibiotic therapy or incremental antibiotic therapy. Centres will be randomized to one therapy and then cross over to the next after 6 months. At one year they will randomize again and then cross over for the final time at 18 months. During each treatment period the randomized antibiotic therapy will be used on all centre patients undergoing a device implant procedure.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Age >= 18 years
Received one of the following procedures:
a) A second or subsequent procedure on the arrhythmia device pocket: i. ICD, pacemaker, CRT-P, CRT-D generator and/or lead replacement ii. Pocket or lead revision iii. System upgrade (insertion or attempted insertion of leads) b) New cardiac resynchronization therapy device implant (pacemaker or ICD)
- Patient is not known to have device infection at the time of the surgery
Contacts and Locations| Contact: Kim Simek | 905-527-4322 ext 40524 |
| Canada, Ontario | |
| Population Health Research Institute | Recruiting |
| Hamilton, Ontario, Canada, L8L 2X2 | |
| Principal Investigator: Carlos Morillo | |
| Principal Investigator: | Andrew Krahn, MD | University of British Columbia |
More Information
No publications provided
| Responsible Party: | Population Health Research Institute |
| ClinicalTrials.gov Identifier: | NCT01628666 History of Changes |
| Other Study ID Numbers: | PADIT Cluster Crossover Study |
| Study First Received: | June 4, 2012 |
| Last Updated: | May 14, 2013 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Population Health Research Institute:
|
Arrhythmia Device Procedure Antibiotics Infection Cluster |
Additional relevant MeSH terms:
|
Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes Anti-Bacterial Agents Bacitracin Cefazolin |
Cephalexin Vancomycin Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Anti-Infective Agents, Local |
ClinicalTrials.gov processed this record on May 19, 2013