Sepsis Clinical Trial
Official title:
Simplified Antibiotic Regimens for the Management of Sepsis in Young Infants in First-level Facilities: Randomized Controlled Trial
This trial evaluates primary care clinic-based simplified antibiotic therapy options for young infants, 0-59 days old in high neonatal mortality settings in peri-urban Karachi where hospital referral is frequently refused by families.
Primary Objective
To evaluate if out-patient (clinic-based) therapy of young infants with possible serious
bacterial infection with 7 days of intramuscular procaine penicillin and gentamicin
(reference therapy) is equivalent to:
- (1) injectable gentamicin once daily and oral amoxicillin twice daily for seven days;
- (2) injectable penicillin and gentamicin once daily for two days followed by oral
amoxicillin twice daily for five days; and
Hypothesis
The proportion of babies who fail therapy at (or before 7) days will be 10% in each group. A
5% or less difference in failure rates will be considered equivalent.
Study Design
This will be a randomized, three arm, open-label equivalence trial among young infants, 0-59
days of age who are diagnosed as having possible serious bacterial infection in one of the
Karachi field clinics, and whose families refuse facilitated hospital referral, and the
infants meet other specified inclusion criteria.
Eligible young infants will be recruited from among those referred to the clinics by trained
community health workers as having clinical signs predictive of possible serious illness
during regular home visits in the surveillance area, or those presenting directly to the
clinics from the areas under pregnancy and newborn surveillance. A diagnosis of possible
sepsis will be made by clinicians if specified clinical criteria are met.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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