Resumen

Este estudio evalúa la seguridad y eficacia de lefamulina, una pleuromutilina, para el tratamiento de adultos con neumonía bacteriana adquirida en la comunidad de moderada a grave.

Descripción detallada

Lefamulina es un antibacteriano potente, semisintético, perteneciente a una clase novedosa conocida como pleuromutilinas. Tanto la forma de dosificación intravenosa (IV) como la oral de lefamulina se están investigando en este estudio. El perfil antibacteriano in vitro de lefamulina incluye los patógenos bacterianos más importantes causantes de infecciones del tracto respiratorio (ITR). El espectro antibacteriano comprende S. pneumoniae, H. influenzae, M. catarrhalis, los patógenos respiratorios atípicos L. pneumophila, C. pneumoniae y M. pneumoniae, S. aureus incluyendo SARM y SARM adquirido en la comunidad, estreptococos β-hemolíticos incluyendo S. pyogenes y S. agalactiae, y Enterococcus faecium incluyendo enterococos resistentes a vancomicina (ERV). Además, como se demostró en estudios de resistencia cruzada, lefamulina mantiene actividad contra aislados clínicos resistentes a los siguientes antimicrobianos (clases): macrólidos, lincosamidas, estreptogramina B, oxazolidinonas, tetraciclinas, β-lactámicos, quinolonas, trimetoprima-sulfametoxazol, mupirocina y vancomicina.

Elegibilidad

Edad mínima: 18 YearsSexo: ALL

Criterios de inclusión

Be male or female at least 18 years of age.
Provide written informed consent and be willing and able to adhere to the study-specified procedures and restrictions.
Have an acute illness (7 days duration) with at least 3 of the following symptoms consistent with a lower respiratory tract infection (new or worsening):
Dyspnea
New or increased cough
Purulent sputum production
Chest pain due to pneumonia
Have at least 2 of the following vital sign abnormalities:
Fever (body temperature \>38.0°C (100.4°F) measured orally or equivalent temperature from an alternate body site) or hypothermia (body temperature \<35.0°C (95.0°F) measured orally or equivalent temperature from an alternate body site)
Hypotension (systolic blood pressure \<90 mmHg)
Tachycardia (heart rate \>100 beats/min)
Tachypnea (respiratory rate \>20 breaths/min)
Have at least 1 other clinical sign or laboratory finding of CABP:
Hypoxemia (i.e., O2 saturation \<90% on room air or while receiving supplemental oxygen at subject's baseline requirement or PaO2 \<60 mmHg)
Auscultatory and/or percussion findings consistent with pneumonia (e.g., crackles, egophony, dullness)
White blood cell (WBC) count \>10,000 cells/mm3 or \<4500 cells/mm3 or \>15% immature neutrophils (bands) regardless of total WBC count
Have radiographically-documented pneumonia within 48 hours before enrollment (i.e., infiltrates in a lobar or multilobar distribution or diffuse opacities on chest x-ray or chest computed tomography scan consistent with acute bacterial pneumonia).
Have a Pneumonia Outcomes Research Team (PORT) Risk Class ≥III.

Criterios de exclusión

Have received more than a single dose of a short-acting oral or IV antibacterial for CABP within 72 hours before randomization
Require concomitant systemic antibacterial therapy potentially effective against CABP pathogens
Have been hospitalized for 2 or more days within 90 days prior to the onset of symptoms or have resided in a nursing home or long-term healthcare facility within 30 days prior to the onset of symptoms. NOTE: Residence in an independent living facility is permitted.
Have confirmed or suspected CABP caused by a pathogen known to be resistant to any of the study drugs (e.g., Pseudomonas aeruginosa, any pathogen of the Enterobacteriaceae Family) or attributable to etiologies other than community acquired bacterial pathogens (e.g., ventilator associated pneumonia, hospital acquired bacterial pneumonia, bacterial aspiration pneumonia, Pneumocystis jiroveci pneumonia or other fungal pneumonia, viral or mycobacterial infection of the lung).
Have a noninfectious cause of pulmonary infiltrates (e.g., pulmonary embolism, chemical pneumonitis from aspiration, hypersensitivity pneumonia, congestive heart failure, bronchial obstruction, lung cancer, cystic fibrosis).
Have confirmed or suspected pleural empyema (does not include sterile parapneumonic effusions).
Require mechanical ventilation.

Estudio fase 3, aleatorizado, doble ciego, doble simulación, para comparar la eficacia y seguridad de lefamulina (BC-3781) versus moxifloxacina (con o sin linezolid complementario) en adultos con neumonía bacteriana adquirida en la comunidad

Resumen

Descripción detallada

Elegibilidad

Criterios de inclusión

Criterios de exclusión

Intervenciones

lefamulin

Moxifloxacin

Linezolid

Ubicaciones

Site 3005

Site 3006

Site 3003

Site 3007

Site 3001

Site 3004

Patrocinadores