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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03329092
Other study ID # C3601002
Secondary ID D4910C000042017-
Status Completed
Phase Phase 3
First received
Last updated
Start date April 5, 2018
Est. completion date February 23, 2023

Study information

Verified date April 2024
Source Pfizer
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

A Phase 3 comparative study to determine the efficacy, safety and tolerability of Aztreonam-Avibactam (ATM-AVI) ± Metronidazole (MTZ) versus Meropenem (MER) ± Colistin (COL) for the treatment of serious infections due to Gram negative bacteria.


Description:

A Phase 3 Prospective, Randomized, Multicenter, Open Label, Central Assessor Blinded, Parallel Group, Comparative Study To Determine The Efficacy, Safety And Tolerability Of Aztreonam-Avibactam (ATM-AVI) ± Metronidazole (MTZ) Versus Meropenem±Colistin (MER±COL) For The Treatment Of Serious Infections Due To Gram Negative Bacteria, Including Metallo Β Lactamase (MBL) - Producing Multidrug Resistant Pathogens, For Which There Are Limited Or No Treatment Options


Recruitment information / eligibility

Status Completed
Enrollment 422
Est. completion date February 23, 2023
Est. primary completion date February 23, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: All subjects: 1. Male or female from 18 years of age 2. Provision of informed consent 3. Confirmed diagnosis of HAP/VAP or cIAI requiring iv antibiotic treatment 4. Female patients are authorized to participate in this clinical study if criteria concerning pregnancy avoidance stated in the protocol are met and negative pregnancy test Additional for cIAI: 1. Diagnosis of cIAI, EITHER: Intra-operative/postoperative enrolment with visual confirmation of cIAI. OR Preoperative enrollment with evidence of systemic inflammatory response, physical and radiological findings consistent with cIAI; confirmation of cIAI at time of surgery within 24 hours of study entry 2. Surgical intervention within 24 hours (before or after) the administration of the first dose of study drug Additional for HAP/VAP: 1. Onset symptoms > 48h after admission to or <7 days after discharge from an inpatient care facility 2. New or worsening infiltrate on CXR or CT scan 3. Clinical signs and symptoms and laboratory findings consistent with HAP/VAP 4. Respiratory specimen obtained for Gram stain and culture following onset of symptoms and prior to randomisation Exclusion criteria: All subjects: 1. APACHE II score > 30 2. Confirmed or suspected infection caused by Gram-negative species not expected to respond to study drug, or Gram-positive species 3. Receipt of >24 hr systemic antibiotic within 48h prior to randomisation (exception in case of treatment failure) 4. History of serious allergy, hypersensitivity (eg, anaphylaxis), or any serious reaction to aztreonam, carbapenem,monobactam or other ß-lactam antibiotics, avibactam, nitroimidazoles or metronidazole, or any of the excipients of the study drugs 5. Known Clostridium difficle associated diarrhoea 6. Requirement for effective concomitant systemic antibacterials or antifungals 7. Creatinine clearance =15 ml/min or requirement or expectation for renal replacement therapy 8. Acute hepatitis, cirrhosis, acute hepatic failure, chronic hepatic failure 9. Hepatic disease as indicated by AST or ALT >3 × ULN. Patients with AST and/or ALT up to 5 × ULN are eligible if acute and documented by the investigator as being directly related infectious process 10. Patient has a total bilirubin >2 × ULN, unless isolated hyperbilirubinemia is directly related to infectious process or due to known Gilbert's disease 11. ALP >3 × ULN. Patients with values >3 × ULN and <5 x ULN are eligible if acute and directly related to the infectious process being treated 12. Absolute neutrophil count <500/mm3 13. Pregnant or breastfeeding or if of child bearing potential, not using a medically accepted effective method of birth control. 14. Any other condition that may confound the results of the study or pose additional risks to the subject 15. Unlikely to comply with protocol 16. History of epilepsy or seizure disorders excluding febrile seizures of childhood Additional for cIAI 1. Diagnosis of abdominal wall abscess; small bowel obstruction or ischemic bowel disease without perforation; traumatic bowel perforation with surgery within 12 hours of diagnosis; perforation of gastroduodenal ulcer with surgery < 24 hours of diagnosis primary etiology is not likely to be infectious 2. Simple cholecystitis, gangrenous cholecystitis without rupture, simple appendicitis, acute suppurative cholangitis, infected necrotizing pancreatitis, pancreatic abscess 3. Prior liver, pancreas or small-bowel transplant 4. Staged abdominal repair (STAR), open abdomen technique or marsupialisation Additional for HAP/VAP 1. APACHE II score < 10 2. Known or high likelihood of Gram-positive monomicrobial infection 3. Lung abscess, pleural empyema, post-obstructive pneumonia 4. Lung or heart transplant 5. Myasthenia gravis

Study Design


Intervention

Drug:
ATM-AVI
(Creatinine clearance > 50 mL/min) 6500 mg ATM/2167 mg (loading dose, extended loading dose and maintenance dose) by iv infusion on Day 1 followed by a total daily dose of 6000 mg ATM/2000 mg AVI (Creatinine clearance 31 - 50 mL/min) 4250 mg ATM/1417 mg AVI on Day 1 (loading dose, extended loading dose, maintenance dose) followed by total daily dose 3000 mg ATM/1000 mg AVI (Creatinine clearance 16 - 30 mL/min) 2700 mg ATM/900 mg AVI on Day 1 (loading dose, extended loading dose maintenance dose), followed by total daily dose 2025 mg ATM/675 mg AVI
MTZ
For cIAI only; 500 mg/100 mL metronidazole iv infusion over 1hr q8h
MER
Where pathogen initially not suspected of being MER-resistant: (Creatinine clearance > 50 mL/min) 1000 mg meropenem by 30 min iv infusion q8h (Creatinine clearance 26 - 50 mL/min) 1000mg meropenem by 30 min iv infusion q12h (Creatinine clearance 16 - 25 mL/min) 500 mg meropenem by 30 min iv infusion q12h Where pathogen initially suspected of being MER-resistant (Creatinine clearance > 50 mL/min) 2000 mg meropenem by 180 min iv infusion q8h (Creatinine clearance 26 - 50 mL/min) 2000 mg meropenem by 180 min iv infusion q12h (Creatinine clearance 16 - 25 mL/min) 1000 mg meropenem by 180 min iv infusion q12h
COL
Loading dose 9 million IU by 30 -60 min iv infusion (6 million IU where weight < 60 kg) followed by one of the following maintenance doses: (Creatinine clearance > 50 mL/min) after a 12h interval, commence maintenance dosing 9 million IU daily in 2 or 3 divided doses by 30 -60 min iv infusions. (Creatinine clearance 31 - 50 mL/min) After a 24 hr interval, commence maintenance dosing of 6 million IU daily in 2 divided doses by 30 -60 min iv infusion (Creatinine clearance 21 - 30 mL/min) After a 24 hr interval, commence maintenance dosing 5 million IU daily in 2 divided doses by 30 -60 min iv infusion (Creatinine clearance 16 - 20 mL/min) after a 24 hr interval, commence maintenance dosing 4 million IU daily in 2 divided doses by 30 -60 min iv infusion

Locations

Country Name City State
Argentina Hospital San Roque Córdoba
Argentina Sanatorio Britanico Rosario Santa FE
Argentina Sanatorio Servicios Medicos SM Santo Tome Santa FE
Bulgaria University Hospital Alexandrovska, Clinic of Anesthesiology and Intensive Care Sofia
Bulgaria University Hospital Queen Joanna ISUL, Clinic of Surgery Sofia
Bulgaria University Multiprofile Hospital for Active Treatment ''Prof.Dr Stoyan Kirkovich''AD Stara Zagora
China Baotou Central Hospital Baotou Inner Mongolia Autonomous Region
China Peking University People's Hospital Beijing
China Peking University Third Hospital Beijing Beijing
China Changsha Third Hospital Changsha Hunan
China Hunan Province People's Hospital Changsha Hunan
China ZhuJiang Hospital of Southern Medical University Guangzhou Guangdong
China Affiliated Hospital of Guilin Medical University Guilin Guangxi
China The First Affiliated Hospital of College of Medicine, Zhejiang University Hangzhou Zhejiang
China Jiangyin People's Hospital Jiangyin Jiangsu
China Jiangyin People's Hospital Jiangyin
China The First people's Hospital of Kunming Kunming Yunnan
China Taizhou Hospital of Zhejiang Province Linhai Zhejiang
China Lishui People's Hospital Lishui Zhejiang
China Nanning First People's Hospital Nanning Guangxi Zhuang Autonomous Region
China Quzhou People's Hospital Quzhou Zhejiang
China Huashan Hospital, Fudan University Shanghai Shanghai
China Shanghai Pulmonary Hospital Shanghai Shanghai
China The First Affiliated Hospital of Shantou University Medical College Shantou Guangdong
China The Second People's Hospital of Shenzhen Shenzhen Guangdong
China Tianjin Union Medical Center Tianjin
China Zhangzhou Municipal Hospital of Fujian Province Zhangzhou Fujian
China Affiliated Hospital of Jiangsu University Zhenjiang Jiangsu
Croatia University Hospital Centre Osijek Osijek
Croatia Klinicki bolnicki centar Rijeka Rijeka Primorsko-goranska Zupanija
Croatia General Hospital "Dr. Josip Bencevic" Slavonski Brod Slavonski Brod
Croatia Clinical Hospital Dubrava Zagreb
Croatia Klinicka bolnica Merkur Zagreb GRAD Zagreb
Czechia Fakultni nemocnice Brno Brno
Czechia Krajska zdravotni, a.s. - Nemocnice Decin, o.z. Decin
Czechia Lekarna Nemocnice Decin, Krajska zdravotni, a.s.- Nemocnice Decin, o.z. Decin
Czechia Public Hospital Kolin, a.s. Kolin III
Czechia Nemocnice Kyjov, prispevkova organizace Kyjov
Czechia Fakultni nemocnice Kralovske Vinohrady Praha 10
Greece General and Chest Diseases Hospital "Sotiria" Athens
Greece General Hospital of Athens "Evangelismos" Athens
Greece General Hospital of Athens "Laiko" Athens
Greece University General Hospital "ATTIKON" Athens
Greece University General Hospital of Heraklion Heraklion, Crete
Greece Koutlimbaneio and Triantafylleio General Hospital of Larissa Larissa
Greece University General Hospital of Larissa Larissa
India M S Ramaiah Medical College and Hospitals Bangalore Karnataka
India Victoria Hospital, Bangalore Medical College and Research Institute Bangalore Karnataka
India Apollo Hospitals Chennai Tamil NADU
India S.R. Kalla Memorial Gastro & General Hospital Jaipur Rajasthan
India Amrita Institute of Medical Sciences & Research Centre Kochi Kerala
India Government Medical College, Kozhikode Kozhikode Kerala
India King George's Medical University Lucknow Uttar Pradesh
India Dayanand Medical College and Hospital Ludhiana
India Kasturba Medical College and Hospital Manipal Karnataka
India JSS Hospital Mysuru Karnataka
India Deenanath Mangeshkar Hospital And Research Centre Pune Maharashtra
India Sahyadri Clinical Research & Development Center Pune
India Sahyadri Specialty Hospital Pune
India Sahyadri Super Speciality Hospital Pune Maharashtra
India Sahyadri Super Specialty Hospital Pune Maharashtra
India King George Hospital Visakhapatnam Andhra Pradesh
Israel Assuta Ashdod University Hospital Ashdod
Israel Rambam Health Care Campus Haifa
Israel Hadassah Medical Organization, Hadassah Medical Center, Ein-Karem Jerusalem
Israel Rabin Medical Center, Beilinson Hospital Petah Tikva
Israel Tel Aviv Sourasky Medical Center Tel Aviv
Israel The Chaim Sheba Medical Center Tel-Hashomer
Israel Shamir Medical Center, Infectious Diseases Unit Zerifin
Italy Azienda Ospedaliero-Universitaria Ospedali Riuniti Foggia
Italy Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Milano Milan
Italy Azienda Ospedaliero Universitaria di Modena Modena
Italy Farmacia Ospedaliera - Direzione Assistenza Farmaceutica Modena
Italy SC di Radiologia - Azienda Ospedaliera Universitaria di Modena Modena
Italy Azienda Ospedaliero-Universitaria Pisana Ospedale Cisanello Pisa
Italy UO Farmaceutica Azienda Ospedaliero-Universitaria Pisana Pisa
Italy UO Radiognastostica 2 Azienda Ospedaliero-Universitaria Pisana Ospedale Cisanello Pisa
Italy Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Presidio Ospedaliero Universitario Santa Udine
Korea, Republic of Gachon University Gil Medical Center - Infectious Disease Incheon Incheon Gwang'yeogsiv
Korea, Republic of Hallym University Kangnam Sacred Heart Hospital Seoul
Korea, Republic of Seoul National University Hospital Seoul
Korea, Republic of The Catholic University of Korea, Eunpyeong St. Mary's Hospital Seoul
Malaysia University Malaya Medical Centre Kuala Lumpur
Malaysia Hospital Sultanah Nur Zahirah Kuala Terengganu Terengganu
Malaysia Hospital Seberang Jaya Seberang Jaya Pulau Pinang
Mexico Hospital Civil Fray Antonio Alcalde Guadalajara Jalisco
Mexico Hospital Universitario "Dr. Jose Eleuterio Gonzalez" Monterrey Nuevo LEON
Philippines Baguio General Hospital and Medical Center Baguio City
Philippines De La Salle Medical and Health Sciences Institute City Of Dasmarinas Cavite
Philippines Davao Doctors Hospital Davao City
Philippines St. Paul's Hospital of Iloilo, Inc. Iloilo City
Philippines West Visayas State University Medical Center Iloilo City
Philippines Makati Medical Center Makati City
Philippines Philippine General Hospital, Central Intensive Care Unit Manila
Philippines Asian Hospital and Medical Center Muntinlupa City
Philippines Quirino Memorial Medical Center Quezon City
Philippines St. Luke's Medical Center Quezon City
Romania Institutul National de Boli Infectioase "Prof. Dr. Matei Bals" Bucuresti
Romania Spitalul Clinic de Boli Infectioase si tropicale "Dr. Victor Babes" Bucuresti
Romania Spitalul Clinic de Boli Infectioase Cluj-Napoca Cluj-Napoca
Romania Spitalul Clinic de Boli Infectioase "Sf. Parascheva" Iasi Iasi
Romania Spitalul Clinic Judetean de Urgenta "Pius Brinzeu" Timisoara
Russian Federation Private Healthcare Institution "Clinical Hospital 'Russian Railroad Medicine, Chelyabinsk'" Chelyabinsk
Russian Federation State Budgetary Healthcare Institution "Regional Clinical Hospital No. 2" of the Ministry of Health Krasnodar
Russian Federation GBUZ of Novosibirsk region "City Clinical Hospital # 2" Novosibirsk
Russian Federation State autonomous institution of healthcare of the Perm Region" City clinical hospital #4" Perm
Russian Federation FGBOU VO "The First St. Petersburg state medical university n. a. I.P. Pavlova" Saint-Petersburg
Russian Federation FSBEI of HE "Smolensk State Medical University" of the Ministry of Health of the RF Smolensk
Russian Federation OGBUZ "Smolensk Regional Clinical Hospital" Smolensk
Russian Federation Scientific Research Institute of Antimicrobial Chemotherapy Smolensk
Spain Hospital Universitari Germans Trias i Pujol Badalona Barcelona
Spain Hospital de la Santa Creu i Sant Pau Barcelona
Spain Parc de Salut Mar- Hospital del Mar Barcelona
Spain Hospital Universitario Reina Sofia Cordoba
Spain Hospital Universitario Ramon y Cajal Madrid
Spain Hospital Regional Universitario de Malaga Malaga
Spain Hospital Universitario Virgen del Rocio Sevilla
Spain Hospital Universitario Virgen Macarena Sevilla
Spain Hospital Universitario Mutua de Terrassa Terrassa Barcelona
Spain Hospital Universitari i Politecnic la Fe Valencia
Spain Complejo Hospitalario Universitario de Vigo. Area Sanitaria de Vigo. Hospital Alvaro Cunqueiro Vigo Pontevedra
Spain Hospital Universitario Miguel Servet Zaragoza
Taiwan National Taiwan University Hospital Yun-Lin Branch Douliou Yunlin
Taiwan Kaohsiung Veterans General Hospital Kaohsiung
Taiwan Kaohsiung Medical University Chung-Ho Memorial Hospital Kaohsiung City
Taiwan Taichung Veterans General Hospital Taichung City
Taiwan Taipei Municipal Wanfang Hospital Taipei
Taiwan National Taiwan University Hospital Taipei City
Thailand Faculty of Medicine Siriraj Hospital Bangkoknoi Bangkok
Thailand Songklanagarind Hospital, Prince of Songkla University Hat Yai Songkhla
Thailand Bamrasnaradura Infectious Disease Institute (BIDI) Muang Nonthaburi
Thailand Srinagarind Hospital, Division of Infectious Disease and Tropical Medicine Muang Khon Kaen
Turkey Ankara University Faculty of Medicine Ankara
Turkey Hacettepe Universitesi Tip Fakultesi Ankara
Turkey T.C. Saglik Bakanligi Ankara Sehir Hastanesi Ankara
Turkey Acibadem Atakent Hospital Istanbul
Turkey Marmara Universitesi Pendik Egitim ve Arastirma Hastanesi Istanbul
Turkey Ege University Faculty of Medicine Izmir
Turkey Kocaeli University Medical Faculty Kocaeli
Turkey Karadeniz Technical University Medical Faculty Farabi Hospital Trabzon
Ukraine OKU "Chernivetska oblasna klinichna likarnia", khirurhichne viddilennia Chernivtsi
Ukraine Komunalnyi zaklad "Miska klinichna likarnia No.4" Dniprovskoi miskoi rady, viddilennia profpatolohii Dnipro
Ukraine KZ "Dnipropetrovska oblasna klinichna likarnia im. I.I. Mechnykova", viddilennia khirurhii ?2 Dnipro
Ukraine Ivano-Frankivska tsentralna miska klin likarnia, viddilennia khirurhii, Ivano-Frankivsk
Ukraine Oblasna klinichna likarnia, viddilennia anesteziolohii ta intensyvnoi terapii Ivano-Frankivsk
Ukraine DU "Instytut zahalnoi ta nevidkladnoi khirurhii imeni V.T. Zaitseva Natsionalnoi akademii medychnykh Kharkiv
Ukraine Kyivska miska klinichna likarnia #4, khirurhichne viddilennia #1 Kyiv
Ukraine Kyivska miska klinichna likarnia No. 3, khirurhichne viddilennia Kyiv
Ukraine Komunalne nekomertsiine pidpryiemstvo Lvivskoi oblasnoi rady Lvivska oblasna klinichna likarnia Lviv
Ukraine Odeska klinichna likarnia na zaliznychnomu transporti filii "Tsentr okhorony zdorovia" aktsionernoho Odesa
Ukraine Komunalne pidpryiemstvo "1-a miska klinichna likarnia Poltavskoi miskoi rady", Poltava
Ukraine Vinnytska oblasna klinichna likarnia im. M.I. Pyrohova Vinnytsia
United States Memorial Medical Center Springfield Illinois
United States Southern Illinois University School of Medicine Springfield Illinois
United States Harbor-UCLA Medical Center Torrance California
United States Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center Torrance California
United States Banner University Medical Center - Tucson Tucson Arizona

Sponsors (3)

Lead Sponsor Collaborator
Pfizer Biomedical Advanced Research and Development Authority, Innovative Medicines Initiative (IMI) COMBACTE-CARE (EU)

Countries where clinical trial is conducted

United States,  Argentina,  Bulgaria,  China,  Croatia,  Czechia,  Greece,  India,  Israel,  Italy,  Korea, Republic of,  Malaysia,  Mexico,  Philippines,  Romania,  Russian Federation,  Spain,  Taiwan,  Thailand,  Turkey,  Ukraine, 

Outcome

Type Measure Description Time frame Safety issue
Other Percentage of Participants With Clinical Cure at End of Treatment (EOT) Visit: ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure at EOT Visit: Micro-ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure at EOT Visit: CE Analysis Set Clinical cure = improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure at EOT Visit: ME Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure by Type of Infection at EOT Visit: ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure by Type of Infection at EOT Visit: CE Analysis Set Clinical cure = improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. At EOT visit (Within 24 hours after last infusion on Day 24)
Other Percentage of Participants With Clinical Cure by Pathogen Resistance Type at EOT Visit: Micro-ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. Percentage of participants with clinical cure by pathogen resistance type (ATM non-susceptible and Meropenem non-susceptible based on European Committee on Antimicrobial Susceptibility Testing [EUCAST] criteria and Clinical and Laboratory Standards Institute [CLSI] criteria, Extended spectrum beta-lactamases [ESBL]-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure by Pathogen Resistance Type at TOC Visit: Micro-ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. Percentage of participants with clinical cure by pathogen resistance type (ATM non-susceptible and Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At TOC (Day 28)
Other Percentage of Participants With Clinical Cure by Pathogen Resistance Type at EOT Visit: ME Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. Percentage of participants with clinical cure by pathogen resistance type (ATM non-susceptible and Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At EOT (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Clinical Cure by Pathogen Resistance Type at TOC Visit: ME Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. Percentage of participants with clinical cure by pathogen resistance type (ATM non-susceptible and Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At TOC visit (Day 28)
Other Percentage of Participants With Favorable Per Participant Microbiological Response at EOT Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Favorable Per Participant Microbiological Response at EOT Visit : ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. At EOT visit (Within 24 hours after last infusion on Day 14)
Other Number of Participants With Favorable Microbiological Response Per-Pathogen at EOT Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Only those pathogens are reported which had more than or equal to 10 isolates for either treatment group. At EOT (Within 24 hours after last infusion on Day 14)
Other Number of Participants With Favorable Microbiological Response Per-Pathogen at at TOC Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Only those pathogens are reported which had more than or equal to 10 isolates for either treatment group. At TOC visit (Day 28)
Other Number of Participants With Favorable Microbiological Response Per-Pathogen at EOT Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Only those pathogens are reported which had more than or equal to 10 isolates for either treatment group. At EOT (Within 24 hours after last infusion on Day 14)
Other Number of Participants With Favorable Microbiological Response Per-Pathogen at TOC Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Only those pathogens are reported which had more than or equal to 10 isolates for either treatment group. At TOC visit (Day 28)
Other Percentage of Participants With Favorable Per-Participant Microbiological Response by Pathogen Resistance Type at EOT Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable microbiological response by pathogen resistance type (ATM non-susceptible and Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At EOT (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Favorable Per-Participant Microbiological Response by Pathogen Resistance Type at TOC Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable microbiological response by pathogen resistance type (ATM non-susceptible and Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At TOC visit (Day 28)
Other Percentage of Participants With Favorable Per-Participant Microbiological Response by Pathogen Resistance Type at EOT Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable microbiological response by pathogen resistance type (ATM non-susceptible, Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At EOT (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Favorable Per-Participant Microbiological Response by Pathogen Resistance Type at TOC Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable microbiological response by pathogen resistance type (ATM non-susceptible, Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At TOC visit (Day 28)
Other Percentage of Participants With Favorable Per-Pathogen Microbiological Response by Pathogen Resistance Type at EOT Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable per-pathogen microbiological response by pathogen resistance type (ATM non-susceptible, Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At EOT (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Favorable Per-Pathogen Microbiological Response by Pathogen Resistance Type at TOC Visit: Micro-ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable per-pathogen microbiological response by pathogen resistance type (ATM non-susceptible, Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At TOC visit (Day 28)
Other Percentage of Participants With Favorable Per-Pathogen Microbiological Response by Pathogen Resistance Type at EOT Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable per-pathogen microbiological response by pathogen resistance type (ATM non-susceptible, Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At EOT (Within 24 hours after last infusion on Day 14)
Other Percentage of Participants With Favorable Per-Pathogen Microbiological Response by Pathogen Resistance Type at TOC Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Percentage of participants with favorable per-pathogen microbiological response by pathogen resistance type (ATM non-susceptible, Meropenem non-susceptible based on EUCAST criteria and CLSI criteria, ESBL-positive, Carbapenemase-positive, Serene Carbapenemase and Metallo-beta-lactamase-positive) is reported in this outcome measure. At TOC visit (Day 28)
Other Number of Participants According to Total Score for the Composite Endpoint of Symptom-Based Objective Clinical Measures: ITT Analysis Set Up to Day 28
Other Number of Participants According to Total Score for the Composite Endpoint of Symptom-Based Objective Clinical Measures: CE Analysis Set CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. Up to Day 28
Other Percentage of Participants Who Died on or Before 14 Days From Randomization: ITT Analysis Set Percentage of participants who died on or before 14 days from randomization is reported in this outcome measure. From randomization up to 14 days
Other Total Length of Hospital Stay up to TOC Visit: ITT Analysis Set The total length of hospital stay was defined as the total number of calendar days on which the participant was in the hospital from the date of randomization up to and including the specified time point of TOC. From randomization up to Day 28
Other Total Length of Hospital Stay up to TOC Visit: CE Analysis Set The total length of hospital stay was defined as the total number of calendar days on which the participant was in the hospital from the date of randomization up to and including the specified time point of TOC. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. From randomization up to Day 28
Other Duration of Study Treatment The duration of therapy in calendar days were calculated as follows: Date of last dose of study drug - date of first dose of study drug +1. From first dose of study treatment until last dose of treatment (Up to 14 days)
Other Length of Intensive Care Unit (ICU) Stay: ITT Analysis Set The total length of ICU stay was defined as the total number of calendar days on which the participant was in ICU for the period from date of randomization until the TOC visit. From randomization until TOC visit (Up to Day 28)
Other Length of Intensive Care Unit (ICU) Stay: CE Analysis Set The total length of ICU stay was defined as the total number of calendar days on which the participant was in ICU for the period from date of randomization until the TOC visit. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. From randomization until TOC visit (Up to Day 28)
Other Number of Participants Admitted to the ICU: ITT Analysis Set Number of participants admitted to the ICU up to TOC were reported in this outcome measure. From randomization until TOC visit (Up to Day 28)
Other Number of Participants Admitted to the ICU: CE Analysis Set The number of participants admitted to the ICU were reported in this outcome measure. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. From randomization until TOC visit (Up to Day 28)
Other Number of Participants With Mechanical Ventilation: ITT Analysis Set Number of participants with mechanical ventilation were reported in this outcome measure. From randomization until TOC visit (Up to Day 28)
Other Number of Participants With Mechanical Ventilation: CE Analysis Set Number of participants with mechanical ventilation were reported in this outcome measure. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. From randomization until TOC visit (Up to Day 28)
Other Duration of Mechanical Ventilation in HAP/VAP Participants: ITT Analysis Set Duration of mechanical ventilation was defined as the total number of calendar days on which the participant required mechanical ventilation from the date of randomization up to TOC. From randomization until TOC visit (Up to Day 28)
Other Duration of Mechanical Ventilation in HAP/VAP Participants: CE Analysis Set Duration of mechanical ventilation was defined as the total number of calendar days on which the participant required mechanical ventilation from the date of randomization up to TOC. CE analysis set: all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. From randomization until TOC visit (Up to Day 28)
Other Number of Participants With Unplanned Surgical Interventions in Complicated Intra-abdominal Infections (cIAI) Participants: ITT Analysis Set Unplanned surgical interventions was defined as those occurring after the initial qualifying surgical intervention and prior to the TOC visit. Number of cIAI participants with unplanned surgical intervention according to clinical response categories of cure and failure is reported in this outcome measure. From randomization until TOC visit (Up to Day 28)
Other Number of Participants With Unplanned Surgical Interventions in cIAI Participants: CE Analysis Set Unplanned surgical interventions was defined as those occurring after the initial qualifying surgical intervention and prior to the TOC visit. Number of cIAI participants with unplanned surgical intervention according to clinical response categories of cure and failure is reported in this outcome measure. From randomization until TOC visit (Up to Day 28)
Primary Percentage of Participants With Clinical Cure at Test of Cure (TOC) Visit: Intent-To-Treat (ITT) Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% confidence interval (CI) was based on Jeffrey's method. At TOC visit (Day 28)
Primary Percentage of Participants With Clinical Cure at TOC Visit: Clinically Evaluable (CE) Analysis Set Clinical cure = improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. CE analysis set:all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. At TOC visit (Day 28)
Secondary Percentage of Participants With Clinical Cure at TOC Visit: Microbiological Intent-To-Treat (Micro-ITT) Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At TOC visit (Day 28)
Secondary Percentage of Participants With Clinical Cure at TOC Visit: Microbiologically Evaluable (ME) Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At TOC visit (Day 28)
Secondary Percentage of Participants With Clinical Cure at TOC Visit by Type of Infection: ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. At TOC visit (Day 28)
Secondary Percentage of Participants With Clinical Cure at TOC Visit by Type of Infection: CE Analysis Set Clinical cure = improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. 95% CI was based on Jeffrey's method. CE analysis set:all participants in ITT analysis set; met criteria for cIAI, or HAP/VAP; received at least 48 hours of study treatment or <48 hours of treatment before discontinuing study drug due to AE; no concomitant antibiotics for any baseline pathogens between first dose and TOC (except protocol-allowed antibiotics); no prior antibiotics other than allowed per protocol; no important protocol deviations; no clinical outcome of indeterminate at TOC; no monomicrobial infections due to non-eligible pathogens and did not have only Gram-positive pathogens. At TOC visit (Day 28)
Secondary Percentage of Participants With Clinical Cure in Participants With Metallo-beta-lactamase (MBL) Positive Pathogen at TOC Visit: Micro-ITT Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. Additionally, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. At TOC visit (Day 28)
Secondary Percentage of Participants With Clinical Cure in Participants With MBL Positive Pathogen at TOC Visit: ME Analysis Set Clinical cure was defined as improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Clinical cure was determined by the Independent Clinical Adjudication Committee. At TOC visit (Day 28)
Secondary Percentage of Participants With Favorable Per-Participant Microbiological Response at TOC Visit: Micro- ITT Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. At TOC visit day (28)
Secondary Percentage of Participants With Favorable Per-Participant Microbiological Response at TOC Visit: ME Analysis Set Participants were determined to have a favorable microbiological response if all baseline pathogens for that participant had a favorable outcome (eradicated or presumed eradicated). Eradication: Absence of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. At TOC Visit (Day 28)
Secondary Percentage of Participants Who Died on or Before 28 Days After Randomization: ITT Analysis Set Percentage of participants who died on or before 28 days after randomization is reported in this outcome measure. From randomization up to 28 days
Secondary Percentage of Participants Who Died on or Before 28 Days After Randomization: Micro-ITT Analysis Set Percentage of participants who died on or before 28 days after randomization is reported in this outcome measure. From randomization up to 28 days
Secondary Plasma Concentration of Aztreonam Plasma concentration for aztreonam according to renal function (augmented, normal and mild, moderate and severe is presented in this outcome measure. Augmented = Creatinine clearance (CrCL) > 150 milliliters per minute (mL/min); Normal & Mild = CrCL > 50 to <=150 mL/min; Moderate = CrCL > 30 to = 50 mL/min; Severe = CrCL > 15 to = 30 mL/min. Anytime between 25 to 30 minutes, 3.25 to 3.5 hours, 5.5 to 6.5 hours, 7.5 to 8.5 hours post start of infusion on Day 1; 2.75 to 3 hours, 3.5 to 4.5 hours, 5 to 6 and 7 to 8 hours post start of infusion on Day 4
Secondary Plasma Concentration of Avibactam Plasma concentration for avibactam according to renal function (augmented, normal and mild, moderate and severe is presented in this outcome measure. Augmented = CrCL > 150 mL/min; Normal & Mild = CrCL > 50 to <=150 mL/min; Moderate = CrCL > 30 to = 50 mL/min; Severe = CrCL > 15 to = 30 mL/min. Anytime between 25 to 30 minutes, 3.25 to 3.5 hours, 5.5 to 6.5 hours, 7.5 to 8.5 hours post start of infusion on Day 1; 2.75 to 3 hours, 3.5 to 4.5 hours, 5 to 6 and 7 to 8 hours post start of infusion on Day 4
Secondary Maximum Plasma Concentration for a Dosing Interval at Steady-State (Cmax, ss) According to Clinical Response by Infection Type at TOC: Aztreonam Population PK predicted maximum plasma concentration for a dosing interval at steady-state (Cmax,ss) for participants who received aztreonam-avibactam in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Clinical response categories included, clinical cure=improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Failure was defined as participants who met any of the following criteria like death (after receiving at least 48 hours of study treatment) and participants who received treatment with further antibiotics for the index infection. Indeterminate was defined as death (after receiving less than 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Percentage of Time That Free Plasma Concentrations Are Above the Minimum Inhibitory Concentration Over a Dosing Interval (%fT>MIC Aztreonam (ATM) of 8 mg/L) According to Clinical Response by Infection Type at TOC: Aztreonam Population PK predicted (%fT>MIC ATM of 8 mg/L) for participants who received aztreonam-avibactam in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Clinical response categories included, clinical cure=improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Failure was defined as participants who met any of the following criteria like death (after receiving at least 48 hours of study treatment) and participants who received treatment with further antibiotics for the index infection. Indeterminate was defined as death (after receiving less than 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Area Under the Plasma Concentration-time Curve Over 24 Hours at Steady-state (AUC24,ss ) According to Clinical Response by Infection Type at TOC: Aztreonam Population PK predicted (AUC24,ss) for participants who received aztreonam-avibactam in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Clinical response categories included, clinical cure=improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Failure was defined as participants who met any of the following criteria like death (after receiving at least 48 hours of study treatment) and participants who received treatment with further antibiotics for the index infection. Indeterminate was defined as death (after receiving less than 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. 0 to 24 hours at TOC (Day 28)
Secondary Maximum Plasma Concentration for a Dosing Interval at Steady-state (Cmax,ss) According to Microbiological Response by Infection Type at TOC: Aztreonam Population PK predicted (Cmax,ss) for participants who received ATM-AVI in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Microbiological response included Favorable =baseline pathogens for participant had a favorable outcome. Eradication: Absence of causative pathogen from an appropriately obtained specimen at site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Unfavorable=persistence, persistence with increasing MIC, or presumed persistence. Persistence= Causative organism still present from appropriately obtained specimen at site of infection. Presumed persistence= Participant assessed as a clinical failure and repeat culture of specimens were not performed/clinically indicated. Indeterminate = death (after receiving < 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Area Under the Plasma Concentration-time Curve Over 24 Hours at Steady-state (AUC24,ss) According to Microbiological Response by Infection Type at TOC: Aztreonam Population PK predicted (AUC24,ss) for participants who received ATM-AVI in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Microbiological response included Favorable =baseline pathogens for participant had a favorable outcome. Eradication: Absence of causative pathogen from an appropriately obtained specimen at site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Unfavorable=persistence, persistence with increasing MIC, or presumed persistence. Persistence= Causative organism still present from appropriately obtained specimen at site of infection. Presumed persistence= Participant assessed as a clinical failure and repeat culture of specimens were not performed/clinically indicated. Indeterminate = death (after receiving < 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. 0 to 24 hours at TOC (Day 28)
Secondary Percentage of Time That Free Plasma Concentrations Are Above the Minimum Inhibitory Concentration Over a Dosing Interval (%fT>MIC Aztreonam (ATM) of 8 mg/L) According to Microbiological Response by Infection Type at TOC: Aztreonam Population PK predicted (%fT>MIC ATM of 8 mg/L) for participants who received ATM-AVI in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Microbiological response included Favorable =baseline pathogens for participant had a favorable outcome. Eradication: Absence of causative pathogen from an appropriately obtained specimen at site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Unfavorable=persistence, persistence with increasing MIC, or presumed persistence. Persistence= Causative organism still present from appropriately obtained specimen at site of infection. Presumed persistence= Participant assessed as a clinical failure and repeat culture of specimens were not performed/clinically indicated. Indeterminate = death (after receiving < 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Area Under the Plasma Concentration-time Curve Over 24 Hours at Steady-state (AUC24,ss) According to Clinical Response by Infection Type at TOC: Avibactam Population PK predicted (AUC24,ss) for participants who received aztreonam-avibactam in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Clinical response categories included, clinical cure=improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Failure was defined as participants who met any of the following criteria like death (after receiving at least 48 hours of study treatment) and participants who received treatment with further antibiotics for the index infection. Indeterminate was defined as death (after receiving less than 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. 0 to 24 hours at TOC (Day 28)
Secondary Maximum Plasma Concentration for a Dosing Interval at Steady-state (Cmax,ss ) According to Clinical Response by Infection Type at TOC: Avibactam Population PK predicted (Cmax,ss) for participants who received aztreonam-avibactam in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Clinical response categories included, clinical cure=improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Failure was defined as participants who met any of the following criteria like death (after receiving at least 48 hours of study treatment) and participants who received treatment with further antibiotics for the index infection. Indeterminate was defined as death (after receiving less than 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Percent of Time That Free Plasma Concentrations Are Above the Threshold Concentration Over a Dosing Interval (%fT>CT of 2.5mg/L) According to Clinical Response by Infection Type at TOC: Avibactam Population PK predicted (%fT>CT of 2.5mg/L) for participants who received aztreonam-avibactam in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Clinical response categories included, clinical cure=improvement in baseline signs and symptoms such that after study treatment, no further antimicrobial treatment for the index infection (i.e., cIAI or HAP/VAP) was required. For cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. Failure was defined as participants who met any of the following criteria like death (after receiving at least 48 hours of study treatment) and participants who received treatment with further antibiotics for the index infection. Indeterminate was defined as death (after receiving less than 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Area Under the Plasma Concentration-time Curve Over 24 Hours at Steady-state (AUC24,ss) According to Microbiological Response by Infection Type at TOC: Avibactam Population PK predicted (AUC24,ss) for participants who received ATM-AVI in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Microbiological response included Favorable =baseline pathogens for participant had a favorable outcome. Eradication: Absence of causative pathogen from an appropriately obtained specimen at site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Unfavorable=persistence, persistence with increasing MIC, or presumed persistence. Persistence= Causative organism still present from appropriately obtained specimen at site of infection. Presumed persistence= Participant assessed as a clinical failure and repeat culture of specimens were not performed/clinically indicated. Indeterminate = death (after receiving<48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. 0 to 24 hours At TOC (Day 28)
Secondary Maximum Plasma Concentration for a Dosing Interval at Steady-state (Cmax,ss (mg/L)) According to Microbiological Response by Infection Type at TOC: Avibactam Population PK predicted (Cmax,ss (mg/L)) for participants who received ATM-AVI in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Microbiological response included Favorable =baseline pathogens for participant had a favorable outcome. Eradication: Absence of causative pathogen from an appropriately obtained specimen at site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Unfavorable=persistence, persistence with increasing MIC, or presumed persistence. Persistence= Causative organism still present from appropriately obtained specimen at site of infection. Presumed persistence= Participant assessed as a clinical failure and repeat culture of specimens were not performed/clinically indicated. Indeterminate = death (after receiving<48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Percent of Time That Free Plasma Concentrations Are Above the Threshold Concentration Over a Dosing Interval; (%fT>CT of 2.5 mg/L) According to Microbiological Response by Infection Type at TOC: Avibactam Population PK predicted (%fT>CT of 2.5 mg/L) for participants who received ATM-AVI in studies C3601002 (NCT03329092) and C3601009 (NCT03580044). Microbiological response included Favorable =baseline pathogens for participant had a favorable outcome. Eradication: Absence of causative pathogen from an appropriately obtained specimen at site of infection. Presumed eradication: repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure. Unfavorable=persistence, persistence with increasing MIC, or presumed persistence. Persistence= Causative organism still present from appropriately obtained specimen at site of infection. Presumed persistence= Participant assessed as a clinical failure and repeat culture of specimens were not performed/clinically indicated. Indeterminate = death (after receiving < 48 hours of study treatment) and for cIAI participants inadequate infection source control at time of initial surgical procedure. At TOC (Day 28)
Secondary Number of Participants With Adverse Events (AEs) and Serious AEs An adverse event (AE) was any untoward medical occurrence in a study participant administered medicinal product,; the event need not necessarily have a causal relationship with product treatment or usage. A serious adverse event (SAE) was any untoward medical occurrence at any dose that: resulted in death; was life-threatening; required inpatient hospitalization or prolongation of hospitalization; resulted in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); resulted in congenital abnormal/birth defect or considered an important medical event. From start of study treatment until end of late follow-up (Up to Day 45)
Secondary Number of Participants With Potentially Clinically Significant Hematology Abnormalities Criteria for potential clinically significant hematology results were as follows: hemoglobin, hematocrit and erythrocyte <0.7*lower limit of normal [LLN] and >30% decrease from Baseline (DFB); >1.3*upper limit of normal (ULN) and >30% increase from Baseline (IFB). Platelet count <0.65*LLN and > 50% decrease from baseline; > 1.5 * ULN and > 100% increase from baseline. leukocyte: < 0.65* LLN and > 60% decrease from baseline; > 1.5* ULN and 100% increase from baseline. Neutrophils/leukocytes < 0.65 * LLN and >75% decrease from baseline; > 1.6*ULN and > 100% increase from baseline. Lymphocytes/leukocytes < 0.25* LLN and > 75% decrease from baseline;> 1.5* ULN and > 100% increase from baseline, Eosinophils/leukocytes, Monocytes/leukocytes, Basophils/leukocytes > 4.0* ULN and > 300% increase from baseline. From start of study treatment until TOC visit (Up to Day 28)
Secondary Number of Participants With Potentially Clinically Significant Clinical Chemistry Abnormalities Albumin < 0.5* LLN and> 50% decrease from baseline (DFB);> 1.5 * ULN and> 50% increase from baseline (IFB). Alkaline phosphatase < 0.5 * LLN and> 80% DFB;> 3.0 * ULN and> 100%. Alanine and Aspartate aminotransferase > 3.0 * ULN and> 100% IFB. Bicarbonate < 0.7 * LLN and > 40% DFB;> 1.3 * ULN and> 40% IFB. Blood urea nitrogen < 0.2 * LLN and > 100% DFB; > 3.0 * ULN and > 200% IFB. Calcium < 0.7 * LLN and > 30% DFB;> 1.3 * ULN and> 30% IFB. Chloride < 0.8 * LLN >and 20% DFB; > 1.2 * ULN and > 20% IFB. Creatinine > 2.0 * ULN and> 100% IFB; Glucose < 0.6 * LLN and> 40% DFB; > 3.0 * ULN and> 200% IFB. Potassium < 0.8 * LLN and > 20% DFB; > 1.2 * ULN and> 20% IFB. Sodium < 0.85 * LLN and> 10% DFB;> 1.1 * ULN and >10% IFB. Bilirubin > 1.5 * ULN and > 100% IFB.; Direct bilirubin > 2.0 * ULN and > 150% IFB. From start of study treatment until At TOC visit (Up to Day 28)
Secondary Number of Participants With Abnormalities in Vital Signs Vitals signs, included blood pressure and, heart rate. Blood pressure (BP) and heart rate were measured using a semiautomatic BP recording device with the participant in a supine position after at least 10 minutes of rest. Criteria for abnormalities included: Systolic BP (millimeters of mercury [mmHg]): value more than (>) 150 and increase from baseline more than equal (>= 30) or value less than (<) 90 and decrease from baseline >= 30; DBP: value > 100 and increase from baseline >=20 or Value < 50 and decrease from baseline >= 20; Heart Rate (beats per minute [BPM]): value < 40 or > 120. From start of study treatment until TOC visit (Up to Day 28)
Secondary Number of Participants With Abnormal Physical Examination Finding A complete physical examination was performed and included an assessment of the following: general appearance including site of infection, skin, head and throat (head, eyes, ears, nose, and throat), lymph nodes, lungs, cardiovascular (CV), abdomen, musculoskeletal, and neurological systems. Screening, End of treatment (up to 24 hours post infusion on Day 14) and Test of Cure (Day 28)
Secondary Number of Participants With Abnormal Clinically Significant Electrocardiogram (ECG) Findings Standard 12-lead ECGs were recorded with the participants in the supine position after the participant had rested in this position for 10 minutes. Clinically significant findings were based on investigators assessment. Baseline (latest non-missing value before start of treatment) and Day 3
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