ACTIVE_NOT_RECRUITING

NICU Antibiotics and Outcomes Trial

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The goal of the NANO trial is to study the longstanding clinical practice of empirically administering intravenous antibiotics to extremely low birthweight (ELBW) infants in the first days of life. In this 802-subject multicenter placebo-controlled randomized clinical trial, the hypothesis to be tested is that the incidence of adverse outcomes is higher in babies receiving empiric antibiotics (EA) in the first week of life compared to babies receiving placebo. The study targets a population of ELBW infants in whom the clinical decision to use or not use EA is currently most challenging -- infants that are clinically stable that did not have a known exposure to intraamniotic infection and were not born preterm for maternal indications. The primary outcome is the composite outcome of late-onset sepsis (LOS), necrotizing enterocolitis (NEC), or death during the index hospitalization. Secondary safety outcomes will include total antibiotic days, days to full enteral feedings, and common morbidities in preterm infants that have previously been linked to EA, e.g. retinopathy of prematurity and bronchopulmonary dysplasia. Weight and length z-score, and head circumference, are standard measures to be collected weekly by clinical team per a standardized protocol.

Official Title

NICU Antibiotics and Outcomes Trial

Quick Facts

Study Start:2020-08-05
Study Completion:2027-06-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:ACTIVE_NOT_RECRUITING

Study ID

NCT03997266

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:Not specified to 4 Hours
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD
Inclusion CriteriaExclusion Criteria
  1. Age 18 years or older
  2. Willing and able to provide informed consent
  3. Able to understand and follow study procedures
  4. Stable medical condition
  1. 1. Infants born for maternal indications via caesarean section with rupture of membranes at delivery, without attempts to induce labor, and without concern for maternal infection
  2. 2. Infants at high risk of EOS
  3. * Infants born to mothers with intrapartum fever (\> 38C) or clinical diagnosis of chorioamnionitis
  4. * Infants born to mothers with previous infant with GBS disease/infection
  5. 3. Infants with respiratory insufficiency requiring invasive mechanical ventilation and FiO2 \> 0.40 or non-invasive ventilation and FiO2 \> 0.60 at time of randomization
  6. 4. Infants with ongoing hemodynamic instability requiring vasopressors or fluid boluses at time of randomization
  7. 5. Clinician concern infant is at high risk for sepsis due to infant physical exam findings or clinical history of mother or infant
  8. 6. Major congenital anomalies
  9. 7. Infants not anticipated to survive beyond 72 hours
  10. 8. Infants who have received antibiotics prior to randomization
  11. 9. Mothers that are \<18 years old at time of enrollment

Contacts and Locations

Study Locations (Sites)

USA Children's and Women's Hospital
Mobile, Alabama, 36688
United States
Sharp Mary Birch Hospital for Women & Newborns
San Diego, California, 92123
United States
Yale University School of Medicine
New Haven, Connecticut, 06520-8064
United States
University of South Flordia Health
Tampa, Florida, 33606
United States
University of Louisville Research Foundation Inc./Kosair Charities Pediatric Clinical Research Unit
Louisville, Kentucky, 40202
United States
The Trustees of Columbia University in the City of New York
New York, New York, 10032-3702
United States
Golisano Children's Hospital at University of Rochester
Rochester, New York, 14642
United States
Maria Fareri Children's Hospital at Westchester Medical Center
Valhalla, New York, 10595
United States
Atrium Health Wake Forest Baptist
Winston-Salem, North Carolina, 27157
United States
Penn State Medical College
Hershey, Pennsylvania, 17033
United States
Pennsylvania Hospital/The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
United States
Alfred I. duPont for Children of the Nemours Foundation
Philadelphia, Pennsylvania, 19107
United States
Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
United States
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
United States

Collaborators and Investigators

Sponsor: Michael Morowitz

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2020-08-05
Study Completion Date2027-06-01

Study Record Updates

Study Start Date2020-08-05
Study Completion Date2027-06-01

Terms related to this study

Keywords Provided by Researchers

  • premature birth
  • human microbiome
  • antibiotics

Additional Relevant MeSH Terms

  • Microbial Colonization
  • Extreme Prematurity
  • Early-Onset Neonatal Sepsis
  • Late-Onset Neonatal Sepsis
  • Necrotizing Enterocolitis of Newborn
  • Death; Neonatal