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| ID | Type | Description | Link |
|---|---|---|---|
| 2022-002817-40 | EudraCT Number |
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The purpose of this study is to evaluate the efficacy of a probiotic, SINQUANON, on the reduction of the occurrence of diarrhea associated with antibiotic use in adults.
The study aims to evaluate the efficacy of a specialized multi-strain probiotic, SINQUANON, on the reduction of the incidence of antibiotic-associated diarrhea in adults and to demonstrate the benefit of administering the specialized multi-strain probiotic as a routine add-on to antibiotic therapy on prevention of antibiotic-associated diarrhea in adults who take antibiotics in the outpatient setting.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Probiotic | Experimental | During the antibiotic dosing (from 5 to 10 days): 2 capsules once a day 2 hours before or 2 hours after antibiotic administration. 14 days following completion of antibiotic dosing: 1 capsule a day. |
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| Placebo | Placebo Comparator | During the antibiotic dosing (from 5 to 10 days): 2 capsules once a day 2 hours before or 2 hours after antibiotic administration. 14 days following completion of antibiotic dosing: 1 capsule a day. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sinquanon | Dietary Supplement | This probiotic food supplement includes fourteen probiotic bacterial strains of Lactobacillus Spp, Bifidobacterium Spp., Bacillus coagulans, Saccharomyces boulardii, three prebiotics and Vitamin-B complex - B1, B2, B3, B6, B7, B9 in an enterosolvent cellulose capsule. The product includes supplementary substances: maltodextrin and magnesium stearate. 2 capsules once a day during the antibiotic dosing. 1 capsule a day for 14 days following completion of antibiotic dosing. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Antibiotic-Associated diarrhea (AAD) | The incidence of AAD is defined as the number of subjects who experience at least one day of diarrhea compared to the total number of subjects enrolled in the given treatment arm. AAD is defined as 3 or more loose or liquid stools (types 5-7 according to Bristol Stool Scale [BSS]) over a period of 24 hours. | By 21+2 days after completion of antibiotic dosing. |
| Measure | Description | Time Frame |
|---|---|---|
| Severity of AAD | Investigator will assess AAD severity using the following modified scale defining AAD as: severe: ≥7 unformed/loose/liquid stools; moderate: 5-6 unformed/loose/liquid stools; mild: a change in the stool pattern 3-4 unformed/loose/liquid stools a day. Investigator's assessment will take into consideration the 24-hour period presenting with the worst severity. | By 21+2 days after completion of antibiotic dosing. |
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Inclusion Criteria:
Male or female subject aged 18 to 60 years.
The subject has given written informed consent after being provided orally with information about the study objective and design, including the administration regimen of the studied probiotic and the study procedures, the available safety data, as well as the rights and obligations of a participant.
The subject initiates oral antibiotic treatment in the ambulatory setting.
Acceptable antibiotic therapy:
Sequential administration of two antibiotics from the allowed groups is permitted, if the total duration of the antibiotic treatment does not exceed 10 days.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Georgi Momekov, Prof PhD | Department of Pharmacology, Pharmacotherapy and Toxicology, Medical University of Sofia | Principal Investigator |
| Karen Dzhambazov, Prof, PhD | University hospital for active treatment Sveti Georgi, Medical University-Plovdiv | Principal Investigator |
| Nikolay Sapundziev, Prof, PhD | Department of Neurosurgery and Otorhinolaryngology, Medical University - Varna | Principal Investigator |
| Milena Encheva, MD, PhD | Military Medical Academy, Bulgaria | Principal Investigator |
| Boris Bogov, Prof, PhD | UMHAT "Sveta Anna" | Principal Investigator |
| Rosen Nikolov, Prof, MD | UMHAT St Ivan Rilski | Principal Investigator |
| Rumen Benchev, Prof | Hill Clinic | Principal Investigator |
| Vladimir Hodzhev, Prof, PhD | University Hospital "St George" | Principal Investigator |
| Spiridon Todorov, Prof, PhD | University Hospital "Tsaritsa Yoanna - ISUL" |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital "St George" | Plovdiv | 4002 | Bulgaria | |||
| University Hospital for Pulmonary Diseases " St. Sofia" |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33207631 | Background | Konstantinidis T, Tsigalou C, Karvelas A, Stavropoulou E, Voidarou C, Bezirtzoglou E. Effects of Antibiotics upon the Gut Microbiome: A Review of the Literature. Biomedicines. 2020 Nov 16;8(11):502. doi: 10.3390/biomedicines8110502. | |
| 26793178 | Background | Francino MP. Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances. Front Microbiol. 2016 Jan 12;6:1543. doi: 10.3389/fmicb.2015.01543. eCollection 2015. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Oct 28, 2024 | |
| Reset | Dec 12, 2024 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Oct 28, 2024 | Dec 12, 2024 |
Prospective, multicenter, double-blind, placebo-controlled, randomized, parallel-arm clinical study
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Investigators will be provided with coded and identical products. Each individual involved in the study will be blinded to the assignment until study completion. Considering the established safety profile of the probiotic strains no necessity is foreseen for urgent unblinding of treatment assignment. With this in mind, no copies of the treatment assignments will be stored at the enrollment sites. If needed, the Investigators may receive information about the assignment of a particular subject only after review and approval by the Medical monitor. No information about the subjects will be shared with the company conducting the randomization.
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| Placebo | Dietary Supplement | The placebo product will have the same appearance as the active product and the same composition but without the live bacteria, prebiotics, and vitamin-B complex. 2 capsules once a day during the antibiotic dosing. 1 capsule a day for 14 days following completion of antibiotic dosing. |
|
| Duration of diarrhea | Number of sequential days with diarrhea. Defined as the time until the first normalization of the stool form according to BSS: presence of one or two sequential normal stools, i.e. "soft and formed" or "hard and formed" - types 1-4 per BSS (or lack of stool) for a period of 24 hours. | By 21+2 days after completion of antibiotic dosing. |
| Antibiotic-associated adverse experiences (abdominal pain, bloating, passing gas, nausea) | Presence of abdominal pain, bloating, passing gass, nausea - Yes/No. | By 21+2 days after completion of antibiotic dosing. |
| Visual-analogue scale for the gastrointestinal quality of life (VAS-QoL) | Measured via Visual-analogue scale for the gastrointestinal quality of life. The subjects will answer the question: "To what extent the abdominal problems impact your quality of life?" This scale has numerical points from 0 to 100. "100" indicates THE WORST quality of life one can imagine, "0" indicates NO problems and THE BEST quality of life one can imagine. | By 21+2 days after completion of antibiotic dosing. |
| Adverse events (AE) | Incidence of mild (for example, self-resolving), moderate (for example, those requiring medical evaluation) and serious AEs (for example, events requiring lasting hospitalization) adverse events. | By 21+2 days after completion of antibiotic dosing. |
| Principal Investigator |
| Vania Youroukova, Prof, PhD | University Hospital for Pulmonary Diseases " St. Sofia" | Principal Investigator |
| Sofia |
| 1431 |
| Bulgaria |
| University Hospital "Tsaritsa Yoanna - ISUL" | Sofia | 1527 | Bulgaria |
| 32087535 | Background | Mekonnen SA, Merenstein D, Fraser CM, Marco ML. Molecular mechanisms of probiotic prevention of antibiotic-associated diarrhea. Curr Opin Biotechnol. 2020 Feb;61:226-234. doi: 10.1016/j.copbio.2020.01.005. Epub 2020 Feb 19. |
| 12052785 | Background | Barbut F, Meynard JL. Managing antibiotic associated diarrhoea. BMJ. 2002 Jun 8;324(7350):1345-6. doi: 10.1136/bmj.324.7350.1345. No abstract available. |
| 26365389 | Background | Szajewska H, Kolodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther. 2015 Nov;42(10):1149-57. doi: 10.1111/apt.13404. Epub 2015 Sep 13. |
| 26216624 | Background | Szajewska H, Kolodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015 Oct;42(7):793-801. doi: 10.1111/apt.13344. Epub 2015 Jul 27. |
| 28008787 | Background | Ouwehand AC. A review of dose-responses of probiotics in human studies. Benef Microbes. 2017 Apr 26;8(2):143-151. doi: 10.3920/BM2016.0140. Epub 2016 Dec 23. |
| 26756877 | Background | Szajewska H, Canani RB, Guarino A, Hojsak I, Indrio F, Kolacek S, Orel R, Shamir R, Vandenplas Y, van Goudoever JB, Weizman Z; ESPGHAN Working Group for ProbioticsPrebiotics. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. J Pediatr Gastroenterol Nutr. 2016 Mar;62(3):495-506. doi: 10.1097/MPG.0000000000001081. |
| 26695080 | Background | Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827. doi: 10.1002/14651858.CD004827.pub4. |
| 20145608 | Background | Gao XW, Mubasher M, Fang CY, Reifer C, Miller LE. Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea prophylaxis in adult patients. Am J Gastroenterol. 2010 Jul;105(7):1636-41. doi: 10.1038/ajg.2010.11. Epub 2010 Feb 9. |
| 39529939 | Derived | Hodzhev V, Dzhambazov K, Sapundziev N, Encheva M, Todorov S, Youroukova V, Benchev R, Nikolov R, Bogov B, Momekov G, Hadjiev V. High-dose Probiotic Mix of Lactobacillus spp., Bifidobacterium spp., Bacillus coagulans, and Saccharomyces boulardii to Prevent Antibiotic-associated Diarrhea in Adults: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial (SPAADA). Open Forum Infect Dis. 2024 Oct 21;11(11):ofae615. doi: 10.1093/ofid/ofae615. eCollection 2024 Nov. |