Trial of Meropenem Versus Piperacillin-Tazobactam on Mortality and Clinial Response
Status:
Active, not recruiting
Trial end date:
2020-12-01
Target enrollment:
Participant gender:
Summary
Infections of the blood are extremely serious and require intravenous antibiotic treatment.
When the infection results from antibiotic resistant bacteria, the choice of antibiotic is an
extremely important decision. Some types of bacteria produce enzymes that may inactivate
essential antibiotics, related to penicillin, called 'beta-lactams'. Furthermore high level
production of these enzymes can occur during therapy and lead to clinical failure, even when
an antibiotic appears effective by laboratory testing. However, this risk of this occurring
in clinical practice has only been well described in a limited range of antibiotic classes in
a type of bacteria called Enterobacter. There is currently uncertainty as to whether a
commonly used, and highly effective antibiotic, called piperacillin-tazobactam is subject to
the same risk of resistance developing while on treatment. Infections caused by Enterobacter
(and other bacteria with similar resistance mechanisms) are often treated with an alternative
drug called meropenem (a carbapenem antibiotic), which is effective but has an extremely
broad-spectrum of activity. Excessive use of carbapenems is driving further resistance to
this antibiotic class - which represent our 'lastline' of antibiotic defence. As such, we
need studies to help us see whether alternatives to meropenem are an effective and safe
choice. No study has ever directly tested whether these two antibiotics have the same
effectiveness for this type of infection. The purpose of this study is to randomly assign
patients with blood infection caused by Enterobacter or related bacteria to either meropenem
or piperacillin/tazobactam in order to test whether these antibiotics have similar
effectiveness.
Phase:
Phase 4
Details
Lead Sponsor:
The University of Queensland
Treatments:
Meropenem Penicillanic Acid Piperacillin Piperacillin, Tazobactam Drug Combination Tazobactam Thienamycins