Cellulitis Clinical Trial
Official title:
Randomized Trial of Trimethoprim-Sulfamethoxazole Versus Placebo Added to Standard Treatment of Uncomplicated Cellulitis in Emergency Department Patients
Verified date | August 2012 |
Source | Brigham and Women's Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | United States: Institutional Review Board |
Study type | Interventional |
The primary aim of this study is to quantify the effectiveness of Bactrim as additional
therapy for the treatment of uncomplicated cellulitis in adults, by comparing: standard
therapy plus Bactrim, versus standard therapy plus placebo.
The primary hypothesis of this study is that, in light of increasing CA-MRSA prevalence,
subjects treated with standard therapy plus Bactrim will have higher cure rates than those
treated with standard therapy plus placebo.
Status | Completed |
Enrollment | 153 |
Est. completion date | May 2012 |
Est. primary completion date | May 2012 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 12 Months and older |
Eligibility |
Inclusion Criteria - Must have cellulitis as defined here: 1. Definition A (preferred definition): Recent onset of soft tissue erythema, considered by the treating clinician to be bacterial in origin, and associated with signs of infection that include at least two of the following: pain, swelling, warmth, fever, lymphangitis, induration, or ulceration. 2. Definition B (ONLY for darkly-pigmented subjects who cannot use Definition A): Recent onset of soft tissue color change, pain, or swelling, considered by the treating clinician to be bacterial in origin, and at least one of the following: warmth, fever, induration, or ulceration - Clinical (non-research) attending physician agrees with treatment with cephalexin until 3 days after all symptoms gone, using our weight-based dosing - Responsible clinical attending physician comfortable with adding trimethoprim-sulfamethoxazole vs. placebo to the above - Subject understands the study and signs written informed consent. - Subject agrees to drink at least 1 liter of fluid per day. - Subject will commit to all follow-up appointments Exclusion Criteria: - Age < 12 months or weight <15 kg - Current skin infection has already been treated - Allergy to sulfa drugs - History of severe allergic reaction to penicillin (defined as anaphylactoid reaction, angioedema, bronchospasm) - Current use of any antibiotic (other than topicals) - Diabetes mellitus - Cellulitis complicated by underlying peripheral vascular disease - Renal insufficiency, defined as patient report, clinical suspicion, or creatinine>1.3 or EGFR<60 on the last-available set of chemistry results in our computer system - Hospital admission required - Presence of > 1 cc of purulent discharge at any time - Cellulitis involving an indwelling vascular, enteric, or urinary catheter - Immunocompromise of any etiology - Pregnancy - Breast feeding - Facial cellulitis (infection is above the clavicles) - Cellulitis associated with marine or freshwater injury, or animal or human bite. (Insect bites not excluded.) - History of glucose-6-phosphate dehydrogenase deficiency - Taking coumadin (warfarin), methotrexate, cisapride, phenytoin (dilantin), digoxin, or dofetilide - Known megaloblastic anemia due to folate deficiency. |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Brigham and Women's Hospital | Boston | Massachusetts |
United States | Children's Hospital Boston | Boston | Massachusetts |
United States | Massachusetts General Hospital | Boston | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Brigham and Women's Hospital |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Relative Efficacy | Proportion of subjects in each arm with successful treatment. Treatment success was assessed by physician examination at 12 +/- 2 days. Non-success was defined as subsequent hospitalization, change in antibiotics, surgical or needle drainage of an abscess, or recurrence of infection within 30 days. Cure was defined as resolution of all symptoms other than mild residual erythema or edema. We confirmed the determination of cure by telephone interview and medical record review at 30 +/- 2 days. |
12 +/- 2 days; 30 +/- 2 days | No |
Secondary | Progression to Abscess | Proportion of subjects in each arm with progression from cellulitis to abscess. | 12 +/- 2 days, 30 days +/- 2 days | No |
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