E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Bacterial Infections and Mycoses [C01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10040054 |
E.1.2 | Term | Sepsis, bacteraemia, viraemia and fungaemia NEC |
E.1.2 | System Organ Class | 100000005053 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the safety and tolerability of ceftaroline for the treatment of Late-onset sepsis in neonates and young infants aged 7 to <60 days |
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E.2.2 | Secondary objectives of the trial |
- To evaluate the PK profile of ceftaroline in neonates and young infants aged 7 to <60 days with Late-onset sepsis
- To evaluate the efficacy of ceftaroline for the treatment of Late-onset sepsis in neonates and young infants aged 7 to <60 days |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Informed consent in writing from parent(s) or other legally-acceptable representative(s)
2. Male or female, gestational age ≥34 weeks, and chronological age 7 to <60 days at the time of screening
3. Diagnosis of sepsis within 36 hours before enrolment, defined as the presence of at least 2 clinical criteria and at least 1 laboratory criterion in the presence of or as a result of suspected or proven bacterial infection that requires IV antibiotic therapy.
4. Patients must meet at least 2 of the following clinical criteria:
(i) Hypothermia (<36°C) OR fever (>38.5°C)
(ii) Bradycardia OR tachycardia OR rhythm instability
(iii) Urine output 0.5 to 1 mL/kg/h OR hypotension OR mottled skin OR
impaired peripheral perfusion
(iv) Petechial rash OR sclerema neonatorum
(v) New onset or worsening of apnoea episodes OR tachypnoea episodes OR
increased oxygen requirements OR requirement for ventilation support
(vi) Feeding intolerance OR poor sucking OR abdominal distension
(vii) Irritability
(viii) Lethargy
(ix) Hypotonia.
5. Patients must meet at least 1 of the following laboratory criteria:
(i) White blood cell count ≤4,000 × 109/L OR ≥20,000 × 109/L
(ii) Immature to total neutrophil ratio >0.2
(iii) Platelet count ≤100,000 × 109/L
(iv) C-reactive protein (CRP) >15 mg/L OR procalcitonin ≥2 ng/mL
(v) Hyperglycaemia OR Hypoglycaemia
(vi) Metabolic acidosis. |
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E.4 | Principal exclusion criteria |
1. Documented history of any hypersensitivity or allergic reaction to any β-lactam antibiotic or aminoglycoside
2. At study entry, has confirmed infection with a pathogen known to be resistant to the combination of ceftaroline fosamil, ampicillin, and the optional aminoglycoside of choice OR confirmed viral, fungal, or parasitic pathogen as the sole cause of infection
3. Refractory septic shock within 24 hours before enrolment that does not resolve after 60 minutes of vasopressor therapy
4. Moderate or severe renal impairment defined as serum creatinine ≥2 times the upper limit of normal (× ULN) for age OR urine output <0.5 mL/kg/h (measured over at least 8 hours) OR requirement for dialysis
5. Evidence of progressively fatal underlying disease, or life expectancy of ≤60 days
6. Documented history of seizure
7. Requiring or currently taking antiretroviral therapy for human immunodeficiency virus (HIV) or a child from an HIV positive mother
8. Proven or suspected central nervous system (CNS) infection (eg, meningitis, brain abscess, subdural abscess), osteomyelitis, endocarditis, or necrotizing enterocolitis (NEC)
9. Any condition (eg, cystic fibrosis, urea cycle disorders), antepartum/peripartum factors, or procedures that would, in the opinion of the investigator, make the patient unsuitable for the study, place a patient at risk, or compromise the quality of data
10. Patient's parent(s) or legally-acceptable representative(s) involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site). Concurrent participation in another clinical study with an investigational product (IP), previous enrolment/participation in this study, or participation in another study of ceftaroline fosamil within 14 days before the intended start of the first dose of study therapy. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The safety analysis will be performed on the Safety Analysis Set (all subjects who received drug) and will include AEs, SAEs, deaths, clinical laboratory parameters and vital signs. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Duration of study including safety follow up visit |
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E.5.2 | Secondary end point(s) |
1. Concentrations of ceftaroline fosamil, ceftaroline, and ceftaroline M-1 in plasma (and if available,
concentrations of ceftaroline and ceftaroline M-1 in cerebrospinal fluid [CSF])
2. Efficacy outcome measures will include clinical outcome at EOT and TOC in the Modified Intent-to- Treat (MITT) Analysis Set. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Treatment period at time of sampling
2. End of Therapy vist and Test of Cure visit |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 17 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Hungary |
Italy |
Spain |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 31 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 31 |
E.8.9.2 | In all countries concerned by the trial days | 0 |