NCT02340000

Brief Summary

The aim is to determine if high-dose amoxicillin/clavulanate is more effective than standard-dose amoxicillin/clavulanate in treating acute bacterial sinusitis in adults seen at a primary care office.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
315

participants targeted

Target at P75+ for phase_4

Timeline
Completed

Started Nov 2014

Typical duration for phase_4

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 18, 2014

Completed
4 days until next milestone

First Submitted

Initial submission to the registry

November 22, 2014

Completed
2 months until next milestone

First Posted

Study publicly available on registry

January 16, 2015

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 27, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 27, 2017

Completed
6 months until next milestone

Results Posted

Study results publicly available

August 24, 2017

Completed
Last Updated

August 24, 2017

Status Verified

August 1, 2017

Enrollment Period

2.3 years

First QC Date

November 22, 2014

Results QC Date

July 16, 2017

Last Update Submit

August 22, 2017

Conditions

Keywords

acute sinusitisamoxicillin/clavulanateadultsoutcomes

Outcome Measures

Primary Outcomes (1)

  • Subjective Improvement - Day 3 (Rating of "a Lot Better" or "no Symptoms")

    rating of "a lot better" or "no symptoms"

    end of 3 days of treatment

Secondary Outcomes (5)

  • SNOT-16 - Day 3

    day 0, end of 3 days of treatment

  • Subjective Improvement - Day 10

    end of 10th day

  • SNOT-16 - Day 10

    day 0, end of 10th day

  • Nasal Colonization With Resistant Bacteria

    baseline

  • Willingness to Take the Study Antibiotic in the Future

    end of 10th day

Study Arms (2)

standard dose

ACTIVE COMPARATOR

amoxicillin/clavulanate 875/125 mg + placebo tablet twice a day for 7 days

Drug: standard dose amoxicillin/clavulanate

high dose

EXPERIMENTAL

Time Period I (November 18, 2014-January 5, 2016): extended-release amoxicillin/clavulanate 1000/62.5 mg 2 tablets (by different manufacturer) twice a day for 7 days Time Period 2 (February 6, 2016-February 27, 2017): immediate-release amoxicillin/clavunate 875/125 mg plus standard immediate-release amoxicillin 875 mg twice a day for 7 days

Drug: high dose amoxicillin/clavulanate

Interventions

amoxicillin/clavulanate 875/125 + placebo bid x 7 days

standard dose

Time Period I: extended-release amoxicillin/clavulanate 1000/62.5 two tablets bid x 7 days Time Period 2: immediate-release amoxicillin/clavulanate 875/125 plus amoxicllin 875 bid x 7 days

high dose

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult 18 or over
  • Meets definition of acute sinusitis by Infectious Disease Society of America (2012)
  • Clinician and participant chose to start antibiotic treatment

You may not qualify if:

  • Previously enrolled in the study
  • Allergic or intolerant to amoxicillin, penicillin, or amoxicillin/clavulanate
  • Specific medication concerns: lactating (since safety of clavulanate unknown); taking allopurinol (increased risk of rash); concurrent mononucleosis (increased risk of rash with amoxicillin); chronic kidney disease with glomerular filtration rate \< 30; significant hepatic impairment; history of antibiotic-associated colitis
  • Cognitive impairment so that unable to give informed consent or give reliable assessment of improvement
  • Need to use high-dose amoxicillin/clavulanate: treatment with amoxicllin or penicillin within the past month (risk of penicillin-resistant pneumococci), very ill patient (though not ill enough to send to hospital); immunocompromise
  • Need to hospitalize the patient

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Albany Medical Center Internal Medicine and Pediatrics

Latham, New York, 12110, United States

Location

Related Publications (2)

  • Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA, Pankey GA, Seleznick M, Volturo G, Wald ER, File TM Jr; Infectious Diseases Society of America. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012 Apr;54(8):e72-e112. doi: 10.1093/cid/cir1043. Epub 2012 Mar 20.

    PMID: 22438350BACKGROUND
  • Matho A, Mulqueen M, Tanino M, Quidort A, Cheung J, Pollard J, Rodriguez J, Swamy S, Tayler B, Garrison G, Ata A, Sorum P. High-dose versus standard-dose amoxicillin/clavulanate for clinically-diagnosed acute bacterial sinusitis: A randomized clinical trial. PLoS One. 2018 May 8;13(5):e0196734. doi: 10.1371/journal.pone.0196734. eCollection 2018.

MeSH Terms

Conditions

Sinusitis

Interventions

AmoxicillinClavulanic Acid

Condition Hierarchy (Ancestors)

Respiratory Tract InfectionsInfectionsParanasal Sinus DiseasesNose DiseasesRespiratory Tract DiseasesOtorhinolaryngologic Diseases

Intervention Hierarchy (Ancestors)

AmpicillinPenicillin GPenicillinsbeta-LactamsLactamsAmidesOrganic ChemicalsSulfur CompoundsHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsClavulanic Acids

Limitations and Caveats

1. Initial formulation of high-dose amox/clav (extended release) became unavailable, so had to switch after participant #180 to immediate-release. 2. The medical students and residents had trouble reaching some participants for follow-up.

Results Point of Contact

Title
Paul Sorum, MD
Organization
Albany Medical College

Publication Agreements

PI is Sponsor Employee
Yes
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Internal Medicine and Pediatrics

Study Record Dates

First Submitted

November 22, 2014

First Posted

January 16, 2015

Study Start

November 18, 2014

Primary Completion

February 27, 2017

Study Completion

February 27, 2017

Last Updated

August 24, 2017

Results First Posted

August 24, 2017

Record last verified: 2017-08

Data Sharing

IPD Sharing
Will not share

Locations