Duration of Antimicrobial Therapy for Paediatric Pneumonia
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Purpose
This study will investigate the feasibility of testing whether a 5-day course of antibiotics is as effective as a 10-day course for the treatment of uncomplicated community-acquired pneumonia (CAP) in children. To accomplish this, previously well children aged 1-10 years who present to McMaster Children's Hospital (MCH) emergency department (ED) with CAP will, if they consent, be randomly chosen to be given either a 5 day or 10 day course of amoxicillin. Neither the child, the child's caregiver, nor the researchers will know whether the child is in the 5- or 10-day antibiotic group. Once the child has received the medication and for two weeks after that, caregivers of children will be asked to complete a daily symptom diary for their child, and will come to MCH at the end of the two week period (between day 14-18) to be assessed by one of the researchers. This information will then be used to compare both groups of children to determine if a 5 days of treatment is non-inferior to 10 days. The investigators hypothesize that running such a trial is feasible.
| Condition | Intervention | Phase |
|---|---|---|
|
Pneumonia |
Drug: amoxicillin |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Short Course Antimicrobial Therapy for Paediatric Community-Acquired Pneumonia: A Pilot Study |
- clinical cure [ Time Frame: 14-18 days post-randomization ] [ Designated as safety issue: No ]Resolution of symptoms and signs of pneumonia.
- absentee days [ Time Frame: 14 d post-randomization ] [ Designated as safety issue: No ]
- number of days of adverse reactions [ Time Frame: 14 d post randomization ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 70 |
| Study Start Date: | November 2012 |
| Estimated Study Completion Date: | October 2013 |
| Estimated Primary Completion Date: | October 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Short course
amoxicillin. high-dose, 5 days
|
Drug: amoxicillin
dosed 75-100 mg/kg/day (standardized dosing)
|
|
Active Comparator: Standard therapy
amoxicillin, high-dose, 10 days
|
Drug: amoxicillin
dosed 75-100 mg/kg/day (standardized dosing)
|
Eligibility| Ages Eligible for Study: | 1 Year to 10 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- children aged 1-10 y presenting to the emergency department
must fulfil definition of 'pneumonia', ie.
1) any one of:
- fever in the ED,
- a recorded fever at home in the 48h prior to presentation, or
WBC > 12 or WBC < 5 in the ED;
2) any one of:
- tachypnoea on exam;
- cough on exam or by history;
- increased work of breathing on exam; or
- auscultatory findings consistent with pneumonia; 3) a lobar consolidation on chest radiograph as judged by the ED physician; and 4) the attending ED physician diagnoses the child with primary CAP
- well enough to be discharged home from the emergency
Exclusion Criteria:
- 2 or more episodes of emesis in the emergency
- history of CF, anatomic lung disease, bronchiectasis, congenital heart disease, repeated aspirations, malignancy, immune suppression, recent prolonged admission to hospital, pneumonia diagnosed within the last month, lung abscess within the past six months, > 24 hours of beta-lactam antibiotic therapy prior to presentation, allergy to penicillin, allergy to food colouring
- evidence of empyaema or necrotizing pneumonia on chest radiograph
Contacts and Locations| Contact: Jeffrey Pernica, MD | 905 521 2100 ext 76185 | pernica@mcmaster.ca |
| Canada, Ontario | |
| McMaster Children's Hospital | Not yet recruiting |
| Hamilton, Ontario, Canada, L8S 4K1 | |
| Principal Investigator: Jeffrey Pernica, MD | |
| Principal Investigator: | Jeffrey Pernica, MD | Hamilton Health Sciences Corporation |
More Information
No publications provided
| Responsible Party: | Jeffrey Pernica, Head, Division of Pediatric Infectious Disease, Hamilton Health Sciences Corporation |
| ClinicalTrials.gov Identifier: | NCT01707485 History of Changes |
| Other Study ID Numbers: | NIF-12303 |
| Study First Received: | October 12, 2012 |
| Last Updated: | October 15, 2012 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Hamilton Health Sciences Corporation:
|
Antibiotics |
Additional relevant MeSH terms:
|
Pneumonia Lung Diseases Respiratory Tract Diseases Respiratory Tract Infections Amoxicillin |
Anti-Infective Agents Anti-Bacterial Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013