Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43851   clinical trials with a EudraCT protocol, of which   7283   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Download PDF

    Clinical Trial Results:
    The early use of Antibiotics for at Risk CHildren with InfluEnza in primary care (ARCHIE): a double-blind randomised placebo-controlled trial

    Summary
    EudraCT number
    2013-002822-21
    Trial protocol
    GB  
    Global end of trial date
    15 Aug 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    05 Mar 2020
    First version publication date
    05 Mar 2020
    Other versions

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    ARCHIE001
    Additional study identifiers
    ISRCTN number
    ISRCTN70714783
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    University of Oxford
    Sponsor organisation address
    Joint Research Office, 1 st floor, Boundary Brook House, Churchill Drive, Headington, Oxford, United Kingdom, OX3 7GB
    Public contact
    Prof Anthony Harnden, University of Oxford, 44 01865 289314, anthony.harnden@phc.ox.ac.uk
    Scientific contact
    Prof Anthony Harnden, University of Oxford, 44 01865 289314, anthony.harnden@phc.ox.ac.uk
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    16 Dec 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    15 Mar 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Aug 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine whether early treatment with co-amoxiclav reduces the likelihood of re-consultation due to clinical deterioration in ‘at risk’ children with influenza/influenza-like illness (ILI) within 28 days of study entry.
    Protection of trial subjects
    We consulted with groups representing both patients and parents when designing the trial and had representatives of on our steering committe. A full risk assessment was conducted before commencing the trial and this was reviewed througout. Informed consent from every participant's parent/guardian was obtained and the trial was reviewed and approved by a Research Ethics Commitee (NRES Committee North West - Liverpool East 13/NW/0621).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Nov 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 271
    Worldwide total number of subjects
    271
    EEA total number of subjects
    271
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    89
    Children (2-11 years)
    179
    Adolescents (12-17 years)
    3
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

    Close Top of page
    Recruitment
    Recruitment details
    Recruitment opened on 11th Feb 2015 and closed 20th April 2018 (seasonal recruitment only running from Oct – end of ILI season following spring). An additional winter season (2017-2018) was added after an extension from the funder. Follow up was completed by 31st July 2019. The trial was not stopped early.

    Pre-assignment
    Screening details
    756 patients were screened for eligibility. Of these, 485 were not eligible and 115 were eligible but declined to consent

    Period 1
    Period 1 title
    Overall (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Data analyst, Carer

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Co-amoxiclav
    Arm description
    Co-amoxiclav 400mg/57mg/5ml Sugar Free Powder for Oral Suspension (70ml)
    Arm type
    Experimental

    Investigational medicinal product name
    Co-amoxiclav
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Dosage was given following British National Formulary Guidelines

    Arm title
    Placebo
    Arm description
    Placebo contains the same excipients as the test product. In order to match the test product for fill weight, bulk density, and viscosity, tests were carried out with different excipients ratios in order to identify the most comparable formulation.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    Dosage was given following British National Formulary Guidelines

    Number of subjects in period 1
    Co-amoxiclav Placebo
    Started
    136
    135
    Completed
    134
    135
    Not completed
    2
    0
         Consent withdrawn by subject
    1
    -
         Physician decision
    1
    -

    Baseline characteristics

    Close Top of page
    Baseline characteristics reporting groups
    Reporting group title
    Co-amoxiclav
    Reporting group description
    Co-amoxiclav 400mg/57mg/5ml Sugar Free Powder for Oral Suspension (70ml)

    Reporting group title
    Placebo
    Reporting group description
    Placebo contains the same excipients as the test product. In order to match the test product for fill weight, bulk density, and viscosity, tests were carried out with different excipients ratios in order to identify the most comparable formulation.

    Reporting group values
    Co-amoxiclav Placebo Total
    Number of subjects
    136 135 271
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    45 44 89
        Children (2-11 years)
    89 90 179
        Adolescents (12-17 years)
    2 1 3
        Adults (18-64 years)
    0 0 0
        From 65-84 years
    0 0 0
        85 years and over
    0 0 0
    Age continuous
    Units: months
        median (inter-quartile range (Q1-Q3))
    41 (19 to 86) 36 (21 to 71) -
    Gender categorical
    Units: Subjects
        Female
    53 55 108
        Male
    83 80 163
    Region
    Region A: Thames Valley & South Midlands, West Midlands, North Thames, North West London, South London; Region B: West of England, South West Peninsula, Cardiff & Vale University Health Board, Aneurin Bevan University Health Board, Abertawe Bro Morgannwg University Health Board; Region C: Greater Manchester, North East and North Cumbria, North West Coast, Yorkshire & Humber; Region D: Kent Surrey & Sussex, Wessex & Region E: Eastern, East Midlands
    Units: Subjects
        Region A
    45 44 89
        Region B
    32 30 62
        Region C
    25 25 50
        Region D
    23 24 47
        Region E
    11 12 23
    Current seasonal influenza vaccination
    Received this season’s seasonal influenza vaccination?
    Units: Subjects
        Yes
    45 45 90
        No
    88 86 174
        Don't know
    3 4 7
    Last year seasonal influenza vaccination
    Received last season’s seasonal influenza vaccination?
    Units: Subjects
        Yes
    48 41 89
        No
    63 72 135
        Don't know
    25 21 46
        Missing
    0 1 1
    Household smoking status
    Units: Subjects
        Non-Smoking
    113 107 220
        Smoking
    21 27 48
        Missing
    2 1 3
    Antibiotics prescribed in the 3 months preceding randomisation
    Units: Subjects
        Yes
    33 25 58
        No
    95 105 200
        Unknown
    5 2 7
        Missing
    3 3 6
    Antivirals taken during current episode
    Units: Subjects
        Yes
    0 0 0
        No
    133 135 268
        Unknown
    2 0 2
        Missing
    1 0 1
    Antipyretics taken during current episode
    Units: Subjects
        Yes
    115 118 233
        No
    19 15 34
        Unknown
    2 2 4
    Other medications taken during current episode
    Units: Subjects
        Yes
    80 71 151
        No
    55 64 119
        Unknown
    1 0 1
    Hib Vaccination Status
    Units: Subjects
        Yes
    124 124 248
        No
    8 5 13
        Unknown
    1 3 4
        Missing
    3 3 6
    PCV Vaccination Received
    Units: Subjects
        Yes
    122 122 244
        No
    10 6 16
        Unknown
    1 4 5
        Missing
    3 3 6
    Any acute consultations in the 12 month period before entering the study
    Units: Subjects
        Yes
    123 119 242
        No
    8 12 20
        Unknown
    2 1 3
        Missing
    3 3 6
    Any Influenza strain
    Units: Subjects
        Yes
    21 16 37
        No
    115 119 234
    Influenza strains
    Units: Subjects
        Influenza A
    3 1 4
        Influenza A/H1-2009
    1 3 4
        Influenza A/H3
    7 6 13
        Other
    125 125 250
    Influenza B
    Units: Subjects
        Yes
    10 7 17
        No
    126 128 254
    Any Parainfluenza strain
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    10 16 26
        No
    126 119 245
    Adenovirus
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    8 15 23
        No
    128 120 248
    Coronavirus
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    15 11 26
        No
    121 124 245
    Human Metapneumovirus
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    8 9 17
        No
    128 126 254
    Rhinovirus/Enterovirus
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    55 64 119
        No
    81 71 152
    Respiratory Syncytial Virus
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    24 24 48
        No
    112 111 223
    Bordetella pertussis
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    0 0 0
        No
    136 135 271
    Mycoplasma pneumoniae
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    3 1 4
        No
    133 134 267
    Chlamydophila pneumoniae
    Other respiratory infections (nasal swab)
    Units: Subjects
        Yes
    0 2 2
        No
    136 133 269
    Risk category - Respiratory
    At risk categories (not mutually exclusive)
    Units: Subjects
        Yes
    99 99 198
        No
    37 36 73
    Risk category - Neurological
    At risk categories (not mutually exclusive)
    Units: Subjects
        Yes
    6 9 15
        No
    130 126 256
    Risk category - Cardiac
    At risk categories (not mutually exclusive)
    Units: Subjects
        Yes
    12 4 16
        No
    124 131 255
    Risk category - Renal
    At risk categories (not mutually exclusive)
    Units: Subjects
        Yes
    3 0 3
        No
    133 135 268
    Risk category - Immunodeficiency
    At risk categories (not mutually exclusive)
    Units: Subjects
        Yes
    1 0 1
        No
    135 135 270
    Heart rate (beats/minute)
    (n=267)
    Units: beats/minute
        arithmetic mean (standard deviation)
    115 ( 22 ) 117 ( 23 ) -
    Respiratory rate
    (n=268)
    Units: breaths/minute
        arithmetic mean (standard deviation)
    27.6 ( 9.1 ) 28.3 ( 9.9 ) -
    Temperature
    (n=270)
    Units: Degrees Celsius
        arithmetic mean (standard deviation)
    37 ( 0.8 ) 37 ( 0.9 ) -
    Total number of acute consultations in the 12 month period before entering the study
    (n=202)
    Units: units
        median (inter-quartile range (Q1-Q3))
    6.0 (3 to 10) 5 (3 to 9) -
    Duration of illness
    Medical history (n=271)
    Units: days
        arithmetic mean (standard deviation)
    2.7 ( 1.2 ) 2.7 ( 1.2 ) -
    Duration of fever
    Medical history (n=266)
    Units: days
        arithmetic mean (standard deviation)
    1.9 ( 1.2 ) 2.2 ( 1.2 ) -

    End points

    Close Top of page
    End points reporting groups
    Reporting group title
    Co-amoxiclav
    Reporting group description
    Co-amoxiclav 400mg/57mg/5ml Sugar Free Powder for Oral Suspension (70ml)

    Reporting group title
    Placebo
    Reporting group description
    Placebo contains the same excipients as the test product. In order to match the test product for fill weight, bulk density, and viscosity, tests were carried out with different excipients ratios in order to identify the most comparable formulation.

    Primary: Proportion of children re-consulting due to clinical deterioration

    Close Top of page
    End point title
    Proportion of children re-consulting due to clinical deterioration
    End point description
    Re-consultation was defined as any subsequent visit to a primary care or other equivalent ambulatory care setting within 28 days of entering the trial. Clinical deterioration was defined as any of: worsening symptoms, development of new symptoms or development of a complication requiring medication or hospitalisation after randomisation. This definition is based on that used by the GRACE (Genomics to combat Resistance against Antibiotics in Community-acquired lower respiratory tract infection in Europe) consortium in relation to lower respiratory tract infections (Little et al., 2013). Date of study entry was defined as the date of randomisation.
    End point type
    Primary
    End point timeframe
    within 28 days of study entry
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    133
    132
    Units: re-consultations
        Yes
    33
    28
        No
    100
    104
    Statistical analysis title
    Primary Outcome Analysis
    Statistical analysis description
    The primary analysis of the primary outcome (i.e. proportion of participants having a re-consultation) was conducted using a log binomial regression model. The model adjusted for region, age (as a continuous variable rather than categorised as per the minimisation criteria) and current seasonal influenza vaccination status (yes, no/unknown). The treatment effect is reported as a relative risk and 95% confidence interval with a corresponding P-value.
    Comparison groups
    Placebo v Co-amoxiclav
    Number of subjects included in analysis
    265
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.513
    Method
    log binomial regression model
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.16
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.75
         upper limit
    1.8

    Secondary: Duration of fever (days)

    Close Top of page
    End point title
    Duration of fever (days)
    End point description
    A fever was defined as a temperature equal to or above 37.5○C. If the temperature was not recorded on any day, and there were not 2 consecutive days of temperature below 37.5○C, this outcome was classed as missing. Duration of fever was defined as the number of days from randomisation until the last day the temperature was recorded as ≥37.5 ○C, followed by being recorded as less than 37.5○C for two consecutive days.
    End point type
    Secondary
    End point timeframe
    The child’s temperature was recorded each day for 28 days or until it had been below 37.5○C for 2 consecutive days.
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    71
    65
    Units: days
        median (inter-quartile range (Q1-Q3))
    0 (0 to 1)
    0 (0 to 1)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    136
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.614
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Duration of Cough

    Close Top of page
    End point title
    Duration of Cough
    End point description
    Duration of cough was computed as the number of days from randomisation until the last day the symptom was recorded as >0, followed by being recorded as 0 (normal/not affected) for two consecutive days.
    End point type
    Secondary
    End point timeframe
    Cough was scored each day for 28 days from 0-6 (0 being normal/not affected and 6 being as bad as it could be). Once all symptoms were scored 0 for 2 consecutive days recording was stopped
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    50
    47
    Units: days
        median (inter-quartile range (Q1-Q3))
    8 (5 to 13)
    11 (7 to 14)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    97
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.199
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Duration of Phlegm

    Close Top of page
    End point title
    Duration of Phlegm
    End point description
    Duration of phlegm was computed as the number of days from randomisation until the last day the symptom was recorded as >0, followed by being recorded as 0 (normal/not affected) for two consecutive days.
    End point type
    Secondary
    End point timeframe
    Phlegm was scored each day for 28 days from 0-6 (0 being normal/not affected and 6 being as bad as it could be). Once all symptoms were scored 0 for 2 consecutive days recording was stopped
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    57
    55
    Units: days
        median (inter-quartile range (Q1-Q3))
    6 (3 to 9)
    6 (3 to 10)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    112
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.513
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Duration of Shortness of breath

    Close Top of page
    End point title
    Duration of Shortness of breath
    End point description
    Duration of Shortness of breath was computed as the number of days from randomisation until the last day the symptom was recorded as >0, followed by being recorded as 0 (normal/not affected) for two consecutive days.
    End point type
    Secondary
    End point timeframe
    Shortness of breath was scored each day for 28 days from 0-6 (0 being normal/not affected and 6 being as bad as it could be). Once all symptoms were scored 0 for 2 consecutive days recording was stopped
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    66
    58
    Units: days
        median (inter-quartile range (Q1-Q3))
    3 (1 to 6)
    5 (2 to 7)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    124
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.119
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Duration of Disturbed sleep

    Close Top of page
    End point title
    Duration of Disturbed sleep
    End point description
    Duration of disturbed sleep was computed as the number of days from randomisation until the last day the symptom was recorded as >0, followed by being recorded as 0 (normal/not affected) for two consecutive days.
    End point type
    Secondary
    End point timeframe
    Disturbed sleep was scored each day for 28 days from 0-6 (0 being normal/not affected and 6 being as bad as it could be). Once all symptoms were scored 0 for 2 consecutive days recording was stopped
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    59
    55
    Units: days
        median (inter-quartile range (Q1-Q3))
    4 (2 to 6)
    7 (3 to 11)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    114
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.021
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Duration of Feeling generally unwell

    Close Top of page
    End point title
    Duration of Feeling generally unwell
    End point description
    Duration of Feeling generally unwell was computed as the number of days from randomisation until the last day the symptom was recorded as >0, followed by being recorded as 0 (normal/not affected) for two consecutive days.
    End point type
    Secondary
    End point timeframe
    Feeling generally unwell was scored each day for 28 days from 0-6 (0 being normal/not affected and 6 being as bad as it could be). Once all symptoms were scored 0 for 2 consecutive days recording was stopped
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    65
    55
    Units: days
        median (inter-quartile range (Q1-Q3))
    5 (3 to 8)
    7 (4 to 8)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.231
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Duration of Interference with normal activities ratings

    Close Top of page
    End point title
    Duration of Interference with normal activities ratings
    End point description
    Duration of Interference with normal activities ratings was computed as the number of days from randomisation until the last day the symptom was recorded as >0, followed by being recorded as 0 (normal/not affected) for two consecutive days.
    End point type
    Secondary
    End point timeframe
    Interference with normal activities ratings was scored each day for 28 days from 0-6 (0 being normal/not affected and 6 being as bad as it could be). Once all symptoms were scored 0 for 2 consecutive days recording was stopped
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    65
    61
    Units: days
        median (inter-quartile range (Q1-Q3))
    4 (2 to 6)
    6 (3 to 8)
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The data for this outcome followed a skewed distribution and could not be transformed to Normality. Therefore, medians and IQRs are presented and a Wilcoxon rank sum test applied to the data. As the Wilcoxon test is a non-parametric univariate test, no adjustment was possible for stratification/minimisation factors.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    126
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.096
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval

    Secondary: Medication or further investigations required

    Close Top of page
    End point title
    Medication or further investigations required
    End point description
    From case notes review, information on whether the child was prescribed antibiotics, other treatments or investigations at re-consultation episode or hospital admission was used to generate a binary variable to indicate medication or further investigations (Yes/No)
    End point type
    Secondary
    End point timeframe
    All medications and investigations had to be within 28 days from randomisation
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    133
    132
    Units: number
        Yes
    41
    33
        No
    92
    99
    Statistical analysis title
    Adjusted log-binomial regression
    Statistical analysis description
    The analysis was carried out using a log-Binomial regression model adjusted for region, age and current vaccination status
    Comparison groups
    Placebo v Co-amoxiclav
    Number of subjects included in analysis
    265
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.274
    Method
    log binomial regression model
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.24
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.84
         upper limit
    1.83

    Secondary: Hospitalisation or death within 28 days

    Close Top of page
    End point title
    Hospitalisation or death within 28 days
    End point description
    ‘Hospitalised’ was defined as admitted to a hospital ward or intensive care unit for at least one overnight stay. The child has a positive response for this outcome if any of the following were recorded as ‘yes’: o Admitted to intensive care unit with an overnight stay and this occurred within 28 days of study entry. o The participant had an acute hospital admission episodes, when he or she has had to spend one or more nights in hospital and the admission occurred within 28 days of study entry. o The participant died and the death occurred within 28 days of study entry. If the date of the event was missing, the CRF was reviewed and followed up in order to attempt to fill in the missing data. If the start date could not be established, the event was not included in the analysis.
    End point type
    Secondary
    End point timeframe
    Within 28 days of study entry
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    133
    132
    Units: number
        Yes
    7
    7
        No
    126
    125
    Statistical analysis title
    Adjusted log-binomial regression
    Statistical analysis description
    The analysis was carried out using a log-Binomial regression model on treatment group, adjusted for age and current vaccination status only
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    265
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.997
    Method
    Log-binomial regression
    Parameter type
    Risk ratio (RR)
    Point estimate
    1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.36
         upper limit
    2.77

    Secondary: Adverse event occurred within 28 days

    Close Top of page
    End point title
    Adverse event occurred within 28 days
    End point description
    End point type
    Secondary
    End point timeframe
    Within 28 days from study entry
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    136
    135
    Units: Number of events
        Yes
    32
    22
        No
    104
    113
    Statistical analysis title
    Adjusted log-binomial regression
    Statistical analysis description
    The analysis was carried out using a log-Binomial regression model adjusted for region, age and current vaccination status
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    271
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.131
    Method
    Log-binomial regression
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.45
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.9
         upper limit
    2.34

    Secondary: Adverse event occurred within 28 days (Including AE information for the participant with no AE start date)

    Close Top of page
    End point title
    Adverse event occurred within 28 days (Including AE information for the participant with no AE start date)
    End point description
    End point type
    Secondary
    End point timeframe
    Within 28 days of study entry
    End point values
    Co-amoxiclav Placebo
    Number of subjects analysed
    136
    135
    Units: Number of events
        Yes
    32
    23
        No
    104
    112
    Statistical analysis title
    Adjusted log-binomial regression
    Statistical analysis description
    The SAP specified that if no adverse event start date was indicated, then the AE should not be counted as it is not known if it commenced within 28 days of randomisation. In this additional analysis, one participant with an AE but no AE start date is counted as having an AE. The analysis was carried out using a log-Binomial regression model adjusted for region, age and current vaccination status.
    Comparison groups
    Co-amoxiclav v Placebo
    Number of subjects included in analysis
    271
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.194
    Method
    Log-binomial regression
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.37
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.85
         upper limit
    2.18

    Adverse events

    Close Top of page
    Adverse events information
    Timeframe for reporting adverse events
    All AEs occurring in participants within 28 days of study entry observed by the investigator or reported by the participant, whether or not attributed to study medication, will be recorded on the CRF
    Adverse event reporting additional description
    Co-amoxiclav is a licensed medication whose most common side-effects are mucocutaneous candidosis (thrush), diarrhoea, nausea, vomiting and rash (occurrence >=1/100 to <1/10) (GlaxoSmithKline UK 2012). If these occur and are non-serious and of mild to moderate severity (based on clinician’s assessment), they will not be recorded
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Co-amoxiclav
    Reporting group description
    Subjects randomised to receive co-amoxiclav

    Reporting group title
    Placebo
    Reporting group description
    Subjects randomised to receive Placebo

    Serious adverse events
    Co-amoxiclav Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 134 (5.97%)
    7 / 135 (5.19%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Nervous system disorders
    Lethargy
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    1 / 134 (0.75%)
    1 / 135 (0.74%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    3 / 134 (2.24%)
    4 / 135 (2.96%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    3 / 134 (2.24%)
    5 / 135 (3.70%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tachypnoea
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Wheezing
         subjects affected / exposed
    2 / 134 (1.49%)
    3 / 135 (2.22%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Bronchiolitis
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    3 / 134 (2.24%)
    3 / 135 (2.22%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngitis
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Fluid intake reduced
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Co-amoxiclav Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    32 / 134 (23.88%)
    23 / 135 (17.04%)
    Injury, poisoning and procedural complications
    Vaccination complication
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Surgical and medical procedures
    Oxygen supplementation
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Lethargy
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Psychomotor hyperactivity
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Adverse drug reaction
         subjects affected / exposed
    3 / 134 (2.24%)
    0 / 135 (0.00%)
         occurrences all number
    3
    0
    Discomfort
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Pyrexia
         subjects affected / exposed
    3 / 134 (2.24%)
    0 / 135 (0.00%)
         occurrences all number
    3
    0
    Ear and labyrinth disorders
    Ear Pain
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Anal fissure
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Constipation
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Diarrhoea
         subjects affected / exposed
    4 / 134 (2.99%)
    1 / 135 (0.74%)
         occurrences all number
    4
    1
    Vomitting
         subjects affected / exposed
    3 / 134 (2.24%)
    3 / 135 (2.22%)
         occurrences all number
    3
    3
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    2 / 134 (1.49%)
    1 / 135 (0.74%)
         occurrences all number
    2
    1
    Cough
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Dyspnoea
         subjects affected / exposed
    1 / 134 (0.75%)
    2 / 135 (1.48%)
         occurrences all number
    1
    2
    Epistaxis
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Hypoxia
         subjects affected / exposed
    1 / 134 (0.75%)
    4 / 135 (2.96%)
         occurrences all number
    1
    4
    Rhinorrhoea
         subjects affected / exposed
    2 / 134 (1.49%)
    0 / 135 (0.00%)
         occurrences all number
    2
    0
    Wheezing
         subjects affected / exposed
    1 / 134 (0.75%)
    1 / 135 (0.74%)
         occurrences all number
    1
    1
    Skin and subcutaneous tissue disorders
    Dermatitis allergic
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Dermatitis diaper
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Rash
         subjects affected / exposed
    4 / 134 (2.99%)
    3 / 135 (2.22%)
         occurrences all number
    4
    3
    Rash generalised
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Rash macular
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Rash papular
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Swelling face
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Irritability
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Myalgia intercostal
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Bronchiolitis
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Conjunctivitis
         subjects affected / exposed
    1 / 134 (0.75%)
    1 / 135 (0.74%)
         occurrences all number
    1
    1
    Ear Infection
         subjects affected / exposed
    1 / 134 (0.75%)
    2 / 135 (1.48%)
         occurrences all number
    1
    2
    hand-foot -and-mouth disease
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Infection
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Lower respiratory tract infection
         subjects affected / exposed
    3 / 134 (2.24%)
    1 / 135 (0.74%)
         occurrences all number
    3
    1
    Otitis externa
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Pneumonia
         subjects affected / exposed
    1 / 134 (0.75%)
    1 / 135 (0.74%)
         occurrences all number
    1
    1
    Pneumonia viral
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Rhinitis
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Scarlet fever
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Tonsillitis
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Viral infection
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Viral rash
         subjects affected / exposed
    2 / 134 (1.49%)
    0 / 135 (0.00%)
         occurrences all number
    2
    0
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 134 (0.75%)
    0 / 135 (0.00%)
         occurrences all number
    1
    0
    Influenza
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Respiratory tract infection
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Fluid intake reduced
         subjects affected / exposed
    0 / 134 (0.00%)
    1 / 135 (0.74%)
         occurrences all number
    0
    1

    More information

    Close Top of page

    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Jun 2017
    1. Addition of investigator and updating of contact details 2. Clarified dosing regime based on BNF guidelines and addition of advice if child under 6kg 3. Clarified data collected during telephone follow up calls including compliance data 4. Addition of vaccination data collection in trial design summary as previously omitted in error 5. Modified eligibility criteria to: a. Remove requirement that children should be registered at a GP surgery in England and replaced with requirement that child should be registered at a GP surgery in UK. b. Clarify that exclusion criterion relating to antibiotic use within the last 72 hours refers specifically to use of antibiotics for treatment of acute infection. c. Clarify exclusion criteria relating to hospitalisation. 6. Addition of hospitalization with pneumonia as a potential risk category 7. Clarify recruitment and screening & eligibility processes to allow flexibility across different sites and site types. 8. Removal of term ‘high’ in reference to nasal swabs to better reflect actual procedure 9. Addition of availability of emergency randomization procedures 10. Changed reference to trial SOP’s to working instructions to reflect PC CTU internal policy that the term SOP's should be used to refer to general and trial procedures while work instructions should be used to refer to trial specific procedures. 11. Clarified SAE reporting procedures 12. Clarified extension of planned trial period to May 2019.
    12 Sep 2018
    1. Change of Chief Investigator (CI) 2. Addition of investigators 3. Clarification that end of trial is considered to be the date of the last data capture of the last trial participant. 4. Gift vouchers to be offered to children participating in the follow up swab sub study 5. Change of Principal Investigators at CRN’s with open sites where former CI has acted as regional PI.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-Fri Apr 19 21:23:32 CEST 2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA