Cefiderocol PK in Patients on ECMO

Sepsis Clinical Trial

Official title:

Ex Vivo Sequestration and Pharmacokinetics of Cefiderocol in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation (ECMO)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04995835
• Other study ID #: HHC-2021-0086
• Status: Recruiting
• Phase: Phase 1
• Start date: July 16, 2021
• Est. completion date: July 16, 2024

Study information

• Verified date: February 2024
• Source: Hartford Hospital
• Contact: Joseph L Kuti, PharmD
• Phone: 8609723612
• Email: joseph.kuti[@]hhchealth.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary life-support for critically ill patients where blood is extracted from the vascular system and circulated by a mechanical pump while it is oxygenated and reinfused into the patient's circulation. It is well known that critically ill patients may experience alterations in antibiotic pharmacokinetics, and as a result, dosing modifications are generally required. There is a need to understand how ECMO circuits affect the pharmacokinetics and disposition of drugs. This study is designed to assess the pharmacokinetics of the new broad-spectrum antibiotic, Cefiderocol, in critically ill patient receiving ECMO.

Description:

This is a prospective, open-label, Phase 1b, pharmacokinetic study of Cefiderocol in 8 critically ill patients receiving ECMO support at Hartford Hospital. Informed consent will be collected from all study participants, legal authorized representative, or their next of kin in order to participate. This is not a treatment study; all participants will receive other antibiotics as necessary to treat any current infection.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 8
• Est. completion date: July 16, 2024
• Est. primary completion date: July 16, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• 18 years of age or older

• On support with veno-venous- or veno-arterial-ECMO

Exclusion Criteria:

• Females who are pregnant or breast-feeding

• History of any moderate or severe hypersensitivity or allergic reaction to any ß-lactam antibiotic (a history of mild rash to a cephalosporin followed by uneventful re-exposure is not a contraindication)

• Receiving Cefiderocol to treat documented or suspected infection within 72 hours of screening, or expected to receive Cefiderocol during the study intervention phase

• Severe renal dysfunction defined as a CrCL < 15 mL/min (as calculated by the Cockcroft Gault equation using actual body weight) or requirement for continuous renal replacement therapy or hemodialysis

• A hemoglobin less than 7.2 gm/dl at baseline

• Acute liver injury, defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 5 times the upper limit of normal, or AST or ALT > 3 times the upper limit of normal with an associated total bilirubin > 2 times upper limit of normal

• Any rapidly progressing disease or immediately life-threatening illness (defined as imminent death within 48 hours in the opinion of the investigator)

• Any condition or circumstance that, in the opinion of the investigator, would compromise the safety of the patient or the quality of study data.

Related Conditions & MeSH terms

• Sepsis

Intervention

Drug:
• Cefiderocol
After receipt of Cefiderocol, blood samples will be collected at various time points to determine the pharmacokinetics of Cefiderocol

Locations

Country	Name	City	State
United States	Hartford Hospital	Hartford	Connecticut
United States	Columbia University/New York Presbyterian Hospital	New York	New York

Sponsors (2)

Lead Sponsor	Collaborator
Joseph L. Kuti, PharmD	Shionogi Inc.

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cefiderocol Clearance	The Clearance in liters/hour of Cefiderocol from the plasma of critically ill patients receiving ECMO.	8 hours
Secondary	Cefiderocol Area Under the Curve (AUC)	The AUC in milligram*hour/liter of Cefiderocol calculated from concentrations collected between zero and 8 hours at steady-state.	8 hours