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| Name | Class |
|---|---|
| Cubist Pharmaceuticals LLC, a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA) | INDUSTRY |
| Indiana University Health | OTHER |
| University of North Carolina | OTHER |
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There is established evidence that adult patients with Cystic Fibrosis (CF) may have altered antibiotic pharmacokinetics compared with non-CF patients. Ceftolozane/Tazobactam is a newly approved broad spectrum intravenous antibiotic, which has potent in vitro activity against multidrug resistant Pseudomonas aeruginosa, the most common pathogen implicated in CF pulmonary exacerbations. This study will determine the pharmacokinetics and tolerability of ceftolozane/tazobactam in 20 adult CF patients admitted for a pulmonary exacerbation at one of 4 participating hospitals in the US. Patients will remain on standard of care IV antibiotics and receive 4-6 doses of ceftolozane/tazobactam 3 grams every 8 hours. Blood will be sampled after the final dose to determine concentrations and pharmacokinetics of ceftolozane and tazobactam. Safety and tolerability will be assessed throughout the 3 day study.
Participants will receive 4-6 doses of ceftolozane/tazobactam 3 grams every 8 hours, in addition to standard intravenous antibiotic therapy selected by the site. Just prior and then after the final dose, a total of six blood samples will be collected to measure ceftolozane and tazobactam concentrations. Data will be fit to a population pharmacokinetic model. The final model will be utilized in a Monte Carlo simulation to determine the probability of several different dosing regimens retaining concentrations above the minimum inhibitory concentration (MIC) for at least 39% of the dosing interval. These data will be utilized to determine an optimized dosing regimen for adults with CF.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ceftolozane/Tazobactam | Experimental | Ceftolozane/Tazobactam 3 grams every 8 hours intravenously for 4-6 doses |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ceftolozane/Tazobactam | Drug | 1 hour intravenous infusion |
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| Measure | Description | Time Frame |
|---|---|---|
| Ceftolozane Clearance | This outcome determines the clearance of ceftolozane over the 8 hour dosing interval. | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
| Ceftolozane Volume of Distribution (Central Compartment) | This outcome determines the volume of distribution of ceftolozane over the 8 hour dosing interval. | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
| Tazobactam Clearance | This outcome determines the clearance of tazobactam over the 8 hour dosing interval. | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
| Tazobactam Volume of Distribution (Central Compartment) | This outcome determines the volume of distribution of tazobactam over the 8 hour dosing interval. | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
| Measure | Description | Time Frame |
|---|---|---|
| Ceftolozane Probability of Target Attainment at 8 mcg/ml | This simulated outcome indicates the likelihood that ceftolozane will retain drug concentrations above the MIC for >/= 60% of the dosing interval at an MIC of 8 mcg/ml when administered as a 3g (2g ceftolozane/1g tazobactam) every 8 hour dose infused over 1 hour. This analysis is conducted via a Monte Carlo simulation using the population pharmacokinetic parameter estimates and dispersion from the 20 participants who contributed pharmacokinetic data to the study. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joseph L Kuti, PharmD | Hartford Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hartford Hospital | Hartford | Connecticut | 06102 | United States | ||
| Riley Hospital for Children at Indiana University Health |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27550351 | Result | Monogue ML, Pettit RS, Muhlebach M, Cies JJ, Nicolau DP, Kuti JL. Population Pharmacokinetics and Safety of Ceftolozane-Tazobactam in Adult Cystic Fibrosis Patients Admitted with Acute Pulmonary Exacerbation. Antimicrob Agents Chemother. 2016 Oct 21;60(11):6578-6584. doi: 10.1128/AAC.01566-16. Print 2016 Nov. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Ceftolozane/Tazobactam | Ceftolozane/Tazobactam 3 grams every 8 hours intravenously for 4-6 doses Ceftolozane/Tazobactam: 1 hour intravenous infusion |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| St. Christopher's Hospital for Children |
| OTHER |
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| 24 hours |
| Indianapolis |
| Indiana |
| 46202 |
| United States |
| University of North Carolina Medical Center | Chapel Hill | North Carolina | 27599 | United States |
| St. Christopher's Hospital for Children | Philadelphia | Pennsylvania | 19134 | United States |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Ceftolozane/Tazobactam | Ceftolozane/Tazobactam 3 grams every 8 hours intravenously for 4-6 doses Ceftolozane/Tazobactam: 1 hour intravenous infusion |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Weight | Mean | Standard Deviation | kilograms |
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| Height | Mean | Standard Deviation | centimeters |
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| Creatinine Clearance | Mean | Full Range | milliliters per minute |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Ceftolozane Clearance | This outcome determines the clearance of ceftolozane over the 8 hour dosing interval. | Posted | Mean | Standard Deviation | Liters per hour | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
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| Primary | Ceftolozane Volume of Distribution (Central Compartment) | This outcome determines the volume of distribution of ceftolozane over the 8 hour dosing interval. | Posted | Mean | Standard Deviation | Liters | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
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| Primary | Tazobactam Clearance | This outcome determines the clearance of tazobactam over the 8 hour dosing interval. | Posted | Mean | Standard Deviation | Liters per hour | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
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| Primary | Tazobactam Volume of Distribution (Central Compartment) | This outcome determines the volume of distribution of tazobactam over the 8 hour dosing interval. | Posted | Mean | Standard Deviation | Liters | 0, 1-1.08, 1.25-1.5, 2-3, 4-5, and 7-8 hours after start of final dose |
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| Secondary | Ceftolozane Probability of Target Attainment at 8 mcg/ml | This simulated outcome indicates the likelihood that ceftolozane will retain drug concentrations above the MIC for >/= 60% of the dosing interval at an MIC of 8 mcg/ml when administered as a 3g (2g ceftolozane/1g tazobactam) every 8 hour dose infused over 1 hour. This analysis is conducted via a Monte Carlo simulation using the population pharmacokinetic parameter estimates and dispersion from the 20 participants who contributed pharmacokinetic data to the study. | The results of this analysis are based on 5000 simulated patients with the same pharmacokinetics to the 20 enrolled participants. | Posted | Number | percent of simulated population | 24 hours |
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Adverse events were collected over the course of the 3 day study.
Laboratory (chemistry, complete blood count, liver function tests, urinalysis) were completed systematically prior to first dose and within 24 hours after completion of the final pharmacokinetic blood sample. All other adverse events collected when reported by the participant or during daily physical examination.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Ceftolozane/Tazobactam | Ceftolozane/Tazobactam 3 grams every 8 hours intravenously for 4-6 doses Ceftolozane/Tazobactam: 1 hour intravenous infusion | 0 | 21 | 0 | 21 | 4 | 21 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Type I Hypersensitivity Reaction | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment | Chest tightness and tongue swelling after receipt of first dose. |
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| Erythema | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Hypokalemia | General disorders | Systematic Assessment |
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| Liver Function Test Elevation | Hepatobiliary disorders | Systematic Assessment |
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| Vaginal Itching | Reproductive system and breast disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Joseph L. Kuti, PharmD | Hartford Hospital | 860-972-3612 | joseph.kuti@hhchealth.org |
| ID | Term |
|---|---|
| D003550 | Cystic Fibrosis |
| D011552 | Pseudomonas Infections |
| ID | Term |
|---|---|
| D010182 | Pancreatic Diseases |
| D004066 | Digestive System Diseases |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007232 | Infant, Newborn, Diseases |
| D016905 | Gram-Negative Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
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| ID | Term |
|---|---|
| C000594038 | ceftolozane, tazobactam drug combination |
| C519491 | ceftolozane |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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