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Trial registered on ANZCTR
Registration number
ACTRN12619001247167
Ethics application status
Approved
Date submitted
31/07/2019
Date registered
10/09/2019
Date last updated
10/09/2019
Date data sharing statement initially provided
10/09/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prospective Clinical Drug-Drug Interaction study between Rifampicin and Fusidic Acid
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Scientific title
Prospective Clinical Drug-Drug Interaction study between Rifampicin and Fusidic Acid in the context of staphylococcal infection
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Secondary ID [1]
298815
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Medication interaction
313765
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Condition category
Condition code
Infection
312173
312173
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0
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Other infectious diseases
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Observation pharmacokinetic study measuring blood levels of Rifampicin and Fusidic acid in patients prescribed this combination for Methicillin-susceptible Staphylococcal infections for a period of 28 +/- 7 days per patient.
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Intervention code [1]
315100
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Composite primary outcome will be the 90% confidence interval around the geometric mean ratio of estimated plasma area under the curve (AUC) of both rifampicin and fusidic acid at steady state when given in combination compared with when given alone.
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Assessment method [1]
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0
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Timepoint [1]
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Day 0, Day 1 and Day 28 (+/-7)
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Secondary outcome [1]
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The result of the treatment of the infection as determined by review of medical records from treating clinicians
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Assessment method [1]
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Timepoint [1]
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28 (+/-7) days
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Secondary outcome [2]
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Adverse effects resulting from the study medications. For example, drug-induced liver injury as assessed by biomarkers of liver function and medical records or participant self-reported nausea and vomiting
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Assessment method [2]
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Timepoint [2]
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28 +/- 7 days
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Eligibility
Key inclusion criteria
-Inpatients with presumed or confirmed staphylococcal infection
-A decision to treat with oral rifampicin and fusidic acid has already been made but not started.
-Treatment with an intravenous beta-lactam antibiotic
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
-Previous adverse reaction to rifampicin or fusidic acid
-Pregnancy
-The taking of other essential medications with a known significant interaction with rifampicin and fusidic acid
-Liver failure
-Unlikely to receive antibiotic treatment for longer than 4 weeks
-Primary intravenous treatment with vancomycin or teicoplanin
-Already on treatment with intravenous rifampicin
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Study design
Purpose
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Duration
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Sample size calculation: Power calculations have been performed within NONMEM using Monte-Carlo mapped power implemented via Perl-Speaks-NONMEM. Base models were taken from previously published population pharmacokinetic models. Based on previous data, for fusidic acid, an increased clearance alone was assumed, while for rifampicin a decreased clearance and volume was assumed. The power to detect these differences between two doses with an alpha of 0.05 (significance level of 5%) was determined and then plotted for each 10% of change. The least sensitive model to detect a change was that of fusidic acid, therefore, the sample size was based on these results. To detect a 30% change (potentially clinically relevant) with a power of 90% then 8 subjects would be required. Considering potential dropouts and incomplete datasets a target number of 12 has been set.
Statistical Analysis: Estimated plasma-time concentration data will be analyzed by non-linear mixed-effects modeling. Once a model is established, pharmacokinetic parameters including AUC and elimination half-life will be predicted. Relationships between predicted model parameters and age, weight, albumin level, bilirubin, hematocrit value, and creatinine clearance rate will be evaluated with a stepwise forward-inclusion and backward-elimination regression analysis. Randomization will be achieved using Microsoft Excel (version 15.35).
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
27/08/2019
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Date of last participant enrolment
Anticipated
30/12/2019
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Actual
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Date of last data collection
Anticipated
28/01/2020
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Actual
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Sample size
Target
12
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
14332
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St Vincent's Private Hospital - Fitzroy
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Recruitment hospital [2]
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The Northern Hospital - Epping
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Recruitment postcode(s) [1]
27335
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3065 - Fitzroy
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Recruitment postcode(s) [2]
27336
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3076 - Epping
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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St Vincent's Hospital Melbourne - Infectious Diseases Research Fund
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Address [1]
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41-55 Victoria Pde Fitzroy Victoria 3065
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Country [1]
303368
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital Melbourne
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Address
41-55 Victoria Pde Fitzroy Victoria 3065
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
303457
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Address [1]
303457
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Country [1]
303457
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Other collaborator category [1]
280879
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University
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Name [1]
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Curtin University
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Address [1]
280879
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Kent St, Bentley WA 6102
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Country [1]
280879
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Australia
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Other collaborator category [2]
280880
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University
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Name [2]
280880
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University of Western Australia
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Address [2]
280880
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35 Stirling Hwy, Crawley WA 6009
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Country [2]
280880
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Australia
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Other collaborator category [3]
280881
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Hospital
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Name [3]
280881
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The Northern Hospital
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Address [3]
280881
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185 Cooper St, Epping VIC 3076
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Country [3]
280881
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303898
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Human Research Ethics Committee - St Vincent's Hospital Melbourne
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Ethics committee address [1]
303898
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41 Victoria Parade, Fitzroy VIC 3065
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Ethics committee country [1]
303898
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Australia
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Date submitted for ethics approval [1]
303898
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Approval date [1]
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13/06/2019
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Ethics approval number [1]
303898
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Summary
Brief summary
For many years, two oral antibiotics, rifampicin (RifadinTM) and fusidic acid (Fucidin TM), have been used effectively in combination in Australia for patients with serious staphylococcal infections. These antibiotics are important as they are one of the few antibiotic combinations available to treat staphylococcal infections resistant to other antibiotics. These antibiotics are known to affect the levels of other drugs that a person might be taking at the same time, however very little is known about how they affect the levels of each other. This study involves taking blood samples from people being treated with rifampicin and fusidic acid and measuring levels of these antibiotics in the blood at different times to see if they affect the levels of each other. Identifying how these antibiotics affect each other could help doctors use these antibiotics in a better way in the future to treat patients and reduce side-effects. Our hypothesis is that there is a drug-drug interaction between rifampicin and fusidic acid but with currently used dosing in Australia, drug levels are appropriate for most patients. We hypothesize that some patients may have elevated or decreased drug levels of one or both drugs and the knowledge of this may be able to help improve treatment for patients in the future.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Craig Aboltins
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Address
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St Vincent's Hospital, Melbourne - 41 Victoria Pde, Fitzroy VIC 3065
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Country
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Australia
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Phone
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+613 9231 2211
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Fax
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+613 9231 4068
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Email
95174
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[email protected]
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Contact person for public queries
Name
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Callum Maggs
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Address
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St Vincent's Hospital, Melbourne - 41 Victoria Pde, Fitzroy VIC 3065
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Country
95175
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Australia
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Phone
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+613 9231 2211
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Fax
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+613 9231 4068
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Email
95175
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[email protected]
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Contact person for scientific queries
Name
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Craig Aboltins
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Address
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St Vincent's Hospital, Melbourne - 41 Victoria Pde, Fitzroy VIC 3065
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Country
95176
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Australia
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Phone
95176
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+613 9231 2211
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Fax
95176
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+613 9231 4068
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Email
95176
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Individual data sharing is not included in the consent process for this study
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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