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| ID | Type | Description | Link |
|---|---|---|---|
| 2018-001082-17 | EudraCT Number |
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COVID-19 seriously affected the study execution as required by the protocol
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The purpose of this study is to assess the efficacy and safety of delafloxacin administered as IV and oral formulation in comparison with Best Available Therapy (BAT) in patients with superficial or deep incisional surgical site infection following a cardiothoracic/related leg or abdominal surgery.
This is a randomized, observer-blinded, active-controlled, parallel-group, multicenter, phase IIIb study for the treatment of incisional, superficial or deep, surgical site infection after cardiothoracic /related leg or abdominal surgery (i.e patients who are at risk of microbiologically resistant infections). IV to be switched to oral delafloxacin will be compared to treatments that represent the best available therapy (BAT) for either cardiothoracic/related leg or abdominal surgical site infection (SSI).
Approximately 600 male and female eligible patients will be randomly assigned in a 1:1 ratio to receive delafloxacin or BAT. For patients who are randomised to BAT, the investigator will choose one out of two treatments available (two available for the cardiothoracic/related leg and two available for abdominal SSI) as most appropriate for patient characteristics and local epidemiological pattern.
Duration of study depends on treatment duration (range: minimum 5 to maximum 14 days, as per Investigator's judgment) followed by visits up to 30 days after end of treatment.
Patients will be hospitalized from Screening (within 30 days from surgery) and will remain hospitalized until considered improved or cure as per Investigator's judgment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Delafloxacin | Experimental | Delafloxacin IV, with the option to switch to delafloxacin oral |
|
| Best Available Therapy | Active Comparator | Cardiothoracic / related leg SSI
In case of suspicion of Gram-negative, additional therapy shall be added as per investigator's choice Abdominal SSI
In case of suspicion of MRSA, if the pre-selected treatment is Piperacillin/Tazobactam, additional therapy shall be added as per investigator's choice. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Delafloxacin | Drug | Powder for solution for infusion 300 mg or tablet 450 mg, BID, for 5 to 14 days |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Clinical Success at Test Of Cure Visit | Clinical Success defined as the clinical response of "Cure" or "improved". Below the definitions:
| 7-14 days after last dose |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital Infection Related Length of Stay (IRLOS) | Length of Stay since beginning of therapy till patient stabilization and considered suitable for hospital discharge | up to 14 days |
| Hospital Length of Stay (LOS) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stefano Margaritora | Hospital Agostino Gemelli | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Agostino Gemelli | Roma | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40908975 | Derived | Belev N, Tein A, Mangialardi G, Nuti A, Marino Merlo G, Scartoni S, Bertolotti M, Lerro M, Margaritora S. A Randomized, Observer-Blinded, Active-Controlled, Phase IIIb Study to Compare IV/Oral Delafloxacin Fixed-Dose Monotherapy With Best Available Treatments in a Microbiologically Enriched Population With Surgical Site Infections: The DRESS Study. Open Forum Infect Dis. 2025 Aug 29;12(9):ofaf476. doi: 10.1093/ofid/ofaf476. eCollection 2025 Sep. |
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In total, 274 patients were screened while 266 patients were randomized and treated (ITT population).
Overall, the recruiment period lasted 13 months, since August 2019 to September 2020. The recruitment was mostly conducted at Abdominal and General surgery departments.
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| ID | Title | Description |
|---|---|---|
| FG000 | Delafloxacin | Delafloxacin IV, with the option to switch to delafloxacin oral Delafloxacin: Powder for solution for infusion 300 mg or tablet 450 mg, BID, for 5 to 14 days |
| FG001 | Best Available Therapy | Cardiothoracic / related leg SSI
In case of suspicion of Gram-negative, additional therapy shall be added as per investigator's choice Abdominal SSI
In case of suspicion of MRSA, if the pre-selected treatment is Piperacillin/Tazobactam, additional therapy shall be added as per investigator's choice. Vancomycin: Powder for solution for infusion 15mg/kg, BID, for 5 to 14 days Linezolid: Solution for infusion or tablet, 600 mg BID, for 5 to 14 days Piperacillin/Tazobactam: Powder for solution for infusion 4/0.5 g, TID, for 5 to 14 days Tigecycline: Powder for solution for infusion 50 mg, TID, for 5 to 14 days |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
ITT analysis population used as reference
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| ID | Title | Description |
|---|---|---|
| BG000 | Delafloxacin | Delafloxacin IV with the option to switch to OS |
| BG001 | Best Available Therapy | Vancomycin and Linezolid for cardiothoracic SSI Piperacillin/Tazobactam and Tigecycline for abdominal SSI |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Number of Participants With Clinical Success at Test Of Cure Visit | Clinical Success defined as the clinical response of "Cure" or "improved". Below the definitions:
| ITT population | Posted | Count of Participants | Participants | 7-14 days after last dose |
|
Adverse events were collected for each participant from the time of ICF signature (Screening) up to to LPLV, i.e. for maximum 45 days.
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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 | Delafloxacin | Delafloxacin IV with the option to switch to delafloxacin OS | 4 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| angina pectoris | Cardiac disorders | MedDRA 23.0 | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| diarrhoea | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Corporate Director of Clinical Sciences | Menarini Ricerche S.p.A. | 0555680 | 9990 | acapriati@menarini-ricerche.it |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 5, 2019 | Aug 6, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Sep 2, 2019 | Aug 6, 2021 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D013530 | Surgical Wound Infection |
| D007239 | Infections |
| ID | Term |
|---|---|
| D014946 | Wound Infection |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C477891 | delafloxacin |
| D014640 | Vancomycin |
| D000069349 | Linezolid |
| D000077725 | Piperacillin, Tazobactam Drug Combination |
| D000078304 | Tigecycline |
| ID | Term |
|---|---|
| D006020 | Glycopeptides |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D010455 | Peptides |
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The study will compare delafloxacin against best available therapy selected by the investigator for the cardiothoracic/leg related or abdominal site infection
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Only the blinded observer will be unaware of the treatment assigned to patient.
| Vancomycin | Drug | Powder for solution for infusion 15mg/kg, BID, for 5 to 14 days |
|
| Linezolid | Drug | Solution for infusion or tablet, 600 mg BID, for 5 to 14 days |
|
| Piperacillin/Tazobactam | Drug | Powder for solution for infusion 4/0.5 g, TID, for 5 to 14 days |
|
| Tigecycline | Drug | Powder for solution for infusion 50 mg, TID, for 5 to 14 days |
|
Length of Stay since Screening till actual hospital discharge
| up to 45 days (Late Follow Up visit) |
| Number of Participants Eligible to Switch to Oral Formulation According to Blinded Observer's Assessment | Blinded assessment based on patient stabilization and ability to tolerate OS diet. In particular, the following details had to be met: Systolic blood pressure normal/not clinically significant abnormal No infection related tachycardia Afebrile status; body temperature <38°C for at least 24 hours* WBC count normalized/not clinically significant abnormal Patient able to tolerate PO diet/to take PO treatment and no GI absorption problem The measure counts only the participants eligible to switch, without taking into account the actually switched. Indeed, only linezolid in the BAT has an equivalent oral formulation suitable for the switch. | up to 14 days |
| Microbiological Response | Documented or presumed eradication or persistence | up to 14 days (End Of Treatment visit) and 7-14 days after last dose (Test Of Cure visit) |
| Physician Decision |
|
| Withdrawal by Subject |
|
| Lack of Efficacy |
|
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Site of infection | Count of Participants | Participants |
|
| Depth of infection | Superficial SSI, involving only skin and subcutaneous tissue of the incision, and at least one of the AND the patient has at least one of the infection symtomps
Or Deep SSI, involving deep soft tissues (e.g. fascia and muscle layers) at the incision site and at least one of the signs or symptoms of infection:
| Count of Participants | Participants |
|
|
|
| Secondary | Hospital Infection Related Length of Stay (IRLOS) | Length of Stay since beginning of therapy till patient stabilization and considered suitable for hospital discharge | CE population | Posted | Mean | Standard Deviation | hours | up to 14 days |
|
|
|
| Secondary | Hospital Length of Stay (LOS) | Length of Stay since Screening till actual hospital discharge | ITT population | Posted | Mean | Standard Deviation | hours | up to 45 days (Late Follow Up visit) |
|
|
|
| Secondary | Number of Participants Eligible to Switch to Oral Formulation According to Blinded Observer's Assessment | Blinded assessment based on patient stabilization and ability to tolerate OS diet. In particular, the following details had to be met: Systolic blood pressure normal/not clinically significant abnormal No infection related tachycardia Afebrile status; body temperature <38°C for at least 24 hours* WBC count normalized/not clinically significant abnormal Patient able to tolerate PO diet/to take PO treatment and no GI absorption problem The measure counts only the participants eligible to switch, without taking into account the actually switched. Indeed, only linezolid in the BAT has an equivalent oral formulation suitable for the switch. | ITT population | Posted | Count of Participants | Participants | up to 14 days |
|
|
|
| Secondary | Microbiological Response | Documented or presumed eradication or persistence | MITT population | Posted | Count of Participants | Participants | up to 14 days (End Of Treatment visit) and 7-14 days after last dose (Test Of Cure visit) |
|
|
|
| 134 |
| 9 |
| 134 |
| 22 |
| 134 |
| EG001 | Best Available Therapy | Vancomycin and Linezolid for cardiothoracic SSI Piperacillin/Tazobactam and Tigecycline for abdominal SSI The results are not reported "per intervention" since the study was not powered to highlight difference between delafloxacin and each reference treatment. The safety analysis aimed to demonstrate that delafloxacin, among the fluoroquinolone class, is atypical showing a favourable safety profile very similar to NON-fluoroquinoles. | 1 | 132 | 14 | 132 | 26 | 132 |
| EG002 | Linezolid | Linezolid IV with the option to switch to delafloxacin OS | 0 | 8 | 1 | 8 | 2 | 8 |
| EG003 | Vancomycin | Vancomycin IV | 0 | 2 | 0 | 2 | 0 | 2 |
| EG004 | Piperacillin/Tazobactam | Piperacillin/Tazobactam IV | 0 | 68 | 10 | 68 | 18 | 68 |
| EG005 | Tigecycline | Tigecycline IV | 1 | 54 | 3 | 54 | 6 | 54 |
| cardiac arrest | Cardiac disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| enterocutaneous fistula | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| ileus | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| intestinal perforation | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| small intestinal obstruction | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| death | General disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| malaise | General disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| abdominal wall abscess | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| clostridium difficile colitis | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| gas gangrene | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| infection | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| septic shock | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| wound infection | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| abdominal wound dehiscence | Injury, poisoning and procedural complications | MedDRA 23.0 | Non-systematic Assessment |
|
| postoperative wound complications | Injury, poisoning and procedural complications | MedDRA 23.0 | Non-systematic Assessment |
|
| wound dehiscence | Injury, poisoning and procedural complications | MedDRA 23.0 | Non-systematic Assessment |
|
| cerebrovascular accident | Nervous system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| pleural effusion | Respiratory, thoracic and mediastinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| pulmonary artery thrombosis | Respiratory, thoracic and mediastinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| pulmonary embolism | Respiratory, thoracic and mediastinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| surgery | Surgical and medical procedures | MedDRA 23.0 | Non-systematic Assessment |
|
| deep vein thrombosis | Vascular disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| nausea | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| pyrexia | General disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| Hypokalaemia | Investigations | MedDRA 23.0 | Non-systematic Assessment |
|
| hypophosphataemia | Investigations | MedDRA 23.0 | Non-systematic Assessment |
|
| headache | Nervous system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| pruritus | Skin and subcutaneous tissue disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| hypertension | Vascular disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| phlebitis | Vascular disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| anaemia | Blood and lymphatic system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| anemia folate deficiency | Blood and lymphatic system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| anemia vitamin B12 deficiency | Blood and lymphatic system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| Iron deficiency anemia | Blood and lymphatic system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| thyroid mass | Endocrine disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| pancreatic calcification | Gastrointestinal disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| device related infection | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| post-operative wound infection | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| urinary tract infection | Infections and infestations | MedDRA 23.0 | Non-systematic Assessment |
|
| Blood alkaline phosphatase increased | Investigations | MedDRA 23.0 | Non-systematic Assessment |
|
| Blood potassium decreased | Investigations | MedDRA 23.0 | Non-systematic Assessment |
|
| White blood cell count increased | Investigations | MedDRA 23.0 | Non-systematic Assessment |
|
| hypomagnaesemia | Investigations | MedDRA 23.0 | Non-systematic Assessment |
|
| Vitamin D deficiency | Metabolism and nutrition disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| paraesthesia | Nervous system disorders | MedDRA 23.0 | Non-systematic Assessment |
|
| vaginal haemorrhage | Reproductive system and breast disorders | MedDRA 23.0 | Non-systematic Assessment |
|
Not provided
| D000602 |
| Amino Acids, Peptides, and Proteins |
| D000081 | Acetamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000085 | Acetates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D023303 | Oxazolidinones |
| D010080 | Oxazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D000078142 | Tazobactam |
| D010397 | Penicillanic Acid |
| D010406 | Penicillins |
| D047090 | beta-Lactams |
| D007769 | Lactams |
| D010878 | Piperacillin |
| D000667 | Ampicillin |
| D010400 | Penicillin G |
| D013457 | Sulfur Compounds |
| D013450 | Sulfones |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D004338 | Drug Combinations |
| D004364 | Pharmaceutical Preparations |
| D013754 | Tetracyclines |
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D011083 | Polycyclic Compounds |
| EOT Visit |
|