Fluconazole Prophylaxis for the Prevention of Candidiasis in Infants Less Than 750 Grams Birthweight

Completed · Phase 3 · Has a placebo group

Conditions studied: Candidiasis

In brief

The most common etiology of infection-related death or neurodevelopmental impairment in neonates with birthweight \<750 g is invasive candidiasis. Over 70% of the premature neonates who develop invasive candidiasis will die or suffer severe, permanent neurologic impairment. Fluconazole has been commonly used off-label in the neonatal intensive care unit, but definitive recommendations for its use in the nursery have been hampered by the limited number of well-designed trials. In neonates weighing \<750 g, appropriate dosing is not known, definitive safety and long-term follow up trials have not been completed, and there have not been well-powered trials conducted to establish the efficacy of the product using mortality as part of the primary endpoint. Three recent proof-of-concept studies suggest that fluconazole will be safe and effective, and a recently completed pharmacokinetic study is providing data to give preliminary dosing guidance. The next logical step in drug development is proposed by this research: to conduct a pivotal trial to determine the safety and efficacy of fluconazole in premature neonates with 2-year neurodevelopmental follow-up assessment. 362 neonates, with a birthweight \<750g, were randomized at 33 US centers, to twice weekly fluconazole (6 mg/kg) or placebo for the first 6 weeks of life. The primary efficacy endpoint will be Candida-free survival at study day 49. The research will establish definitive dosing, safety, and efficacy of fluconazole; it will also provide critical information on the effects of fluconazole on neurodevelopmental impairment and antifungal resistance. Potential Impact: Approximately 17,000 neonates are born \<750 grams each year in the United States. Over 5000 will die or develop invasive Candida infections. Demonstrating safety and efficacy of fluconazole in preterm neonates will improve the survivability and long term outcomes for these neonates.

Key facts

Study ID

NCT00734539

Run by

Daniel Benjamin

People needed

362

Starts

2008-11-01

Expected to finish

2013-04-01

Last updated by the study team

2019-03-01

Who can join

Age: 0 and older, up to 0. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Informed consent from the legally authorized representative.
• > 48 hours of age and < 120 hours old at time of first drug administration
• < 750 g birth weight
• Negative blood cultures for Candida

You may not qualify if…

• History of a hypersensitivity or severe vasomotor reaction to any azole
• receiving antifungal therapy for suspected/proven invasive fungal infection
• medical condition, in the opinion of the Investigator, may create an unacceptable additional risk
• diagnosed with invasive candidiasis or congenital Candida infection.
• liver failure (AST and ALT > 250 U/L)
• renal failure (creatinine > 2 mg/dL)
• major lethal congenital or genetic anomalies
• triplet or higher multiple gestations

Where it is running

• University of Alabama at Birmingham — Birmingham, Alabama, United States
• University of Arkansas for Medical Sciences — Little Rock, Arkansas, United States
• Arkansas Childrens Hospital — Little Rock, Arkansas, United States
• Children's Hospital of Orange County — Orange, California, United States
• University of California-San Diego — San Diego, California, United States
• University of Florida — Gainesville, Florida, United States
• Baptist Medical Center — Jacksonville, Florida, United States
• Shands Jacksonville Medical Center — Jacksonville, Florida, United States
• University of Miami — Miami, Florida, United States
• Riley Hospital — Indianapolis, Indiana, United States
• Memorial Hospital — South Bend, Indiana, United States
• Wesley Medical Center — Wichita, Kansas, United States
• Kosair Children's Hospital — Louisville, Kentucky, United States
• Tulane University School of Medicine — New Orleans, Louisiana, United States
• Wayne State University — Detroit, Michigan, United States
• University of Minnesota, Fairview Medical Center — Minneapolis, Minnesota, United States
• University of Nevada School of Medicine — Las Vegas, Nevada, United States
• West Jersey Hospital - Voorhees — Voorhees Township, New Jersey, United States
• Brookdale University Medical Center — Brooklyn, New York, United States
• Kings County Hospital Center — Brooklyn, New York, United States
• SUNY Dowstate Medical Center — Brooklyn, New York, United States
• Columbia University Medical Center — New York, New York, United States
• Duke University Medical Center — Durham, North Carolina, United States
• Pitt County Memorial Hospital — Greenville, North Carolina, United States
• Akron Children's Hospital — Akron, Ohio, United States

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.