RECRUITING

Optimization of Beta-lactam Dosing in Critically Ill Patients With Cystatin C (OPTIMIZE-GNI)

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 purpose of this study is to evaluate the abilities of Cystatin C (CysC) and CysC-based estimated Glomerular Filtration Rate (eGFR) equations to characterize the pharmacokinetics (PK) profiles of meropenem and cefepime relative to Serum Creatinine (SCR), Serum Creatinine based Equation (SCRE)and iohexol at the population and individual levels in critically ill adult patients with suspected or documented AMR Gram-negative infections. We hypothesize that CysC and CysC-based eGFR equations will characterize the PK profiles of meropenem and cefepime at the population and individual levels with greater accuracy and precision than SCR and SCREs. Iohexol will be administered to patients enrolled in the study and serve as the reference indicator of measured Glomerular Filtration Rate (mGFR), which is the gold standard assessment of kidney function. We hypothesize that the predictive performances of CysC and CysC-based eGFR equations in estimating the PK profiles of meropenem and cefepime at the population and individual levels will be comparable to iohexol. The information obtained in this study will be used to develop PK/pharmacodynamics (PD) optimized meropenem and cefepime dosing schemes based on the renal function biomarker population PK (PopPK) model with the best predictive performance for clinical use in the treatment of critically ill adult patients with suspected or documented AMR Gram-negative infections and varying degrees of renal function. The primary objective of this study is to compare the abilities of renal function biomarkers (CysC, CysC-based eGFR equations, SCR, SCREs) relative to iohexol to characterize the PK profiles of meropenem and cefepime in critically ill adult patients with suspected or documented AMR Gram-negative infections.

Official Title

Optimization of Beta-lactam Dosing in Critically Ill Patients With Suspected or Documented Antimicrobial Resistant Gram-Negative Infections With Cystatin-C (OPTIMIZE-GNI)

Quick Facts

Study Start:2025-02-12
Study Completion:2026-10-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT06709521

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:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Age \>/=18 years at the time of enrollment.
  2. 2. Residing in an ICU.
  3. 3. Documented or suspected AMR Gram-negative infection for which the prospective participant is receiving meropenem or cefepime as part of their clinical management.
  4. 4. Expectation that the prospective participant will reside in the ICU and receive meropenem or cefepime for the duration of the study, and that all study procedures will be completed.
  5. 5. Expectation that IV access will be sufficient for drug infusion and either IV or arterial access will be sufficient to allow for all protocol-required blood sampling to occur.
  6. 6. The prospective participant, or their legally authorized representative (LAR), is able and willing to provide signed informed consent
  1. 1. Prospective participant has a documented hypersensitivity or allergic reaction to iohexol, any contrast agents, or iodine.
  2. 2. Prospective participant has a documented prior history of severe cutaneous reactions to iohexol, any contrast agents, or iodine.
  3. 3. Prospective participant received iohexol within one calendar day prior to enrollment or the expectation that they will receive iohexol for clinical care (i.e., SOC) during the study.
  4. 4. Prospective participant had a major surgery\* within two calendar days prior to enrollment.
  5. 5. Prospective participant had a recent (within 6 months) burn involving \> 25% of total body surface area.
  6. 6. Prospective participant had a penetrating injury\* within two calendar days prior to enrollment.
  7. 7. Prospective participant is currently receiving or is expected to receive any type of renal replacement therapy including hemodialysis or extra corporeal membrane oxygenation, during study period.
  8. 8. Prospective participant has a documented diagnosis of diabetes with a serum creatinine obtained for clinical care purposes (i.e., SOC results) \>3 mg/dL during screening.
  9. 9. Prospective participant has documented severe thyrotoxicosis as noted in medical records during screening.
  10. 10. Prospective participant is homozygous for sickle cell disease as noted in medical history/records.
  11. 11. Prospective participant has a documented diagnosis of hepatorenal syndrome as noted in medical records during screening.
  12. 12. Prospective participant is anuric\* for \>/ = 1 calendar day during screening AND has any one of the following documented conditions as noted in medical history/records:
  13. * Pheochromocytoma
  14. * Myelomatosis
  15. * Multiple myeloma
  16. * Paraproteinemia \*Anuria is defined as urine production \<100 mL in a calendar day
  17. 13. Prospective participant is pregnant or breastfeeding.
  18. 14. Prospective participant received or is expected to receive albumin from one calendar day prior to enrollment to end of study period.
  19. 15. Prospective participant received or is expected to receive \>/= 3 units of any blood product other than platelets from one calendar day prior to enrollment to end of study period.
  20. 16. Any condition that, in the judgment of the investigator, precludes participation because it could affect the prospective participant's safety.

Contacts and Locations

Study Contact

Thomas Lodise
CONTACT
15186947292
Thomas.lodise@acphs.edu

Study Locations (Sites)

Harbor UCLA Medical Center - Medicine - Infectious Diseases
Torrance, California, 90502-2006
United States
Torrance Memorial Medical Center
Torrance, California, 90505
United States
Henry Ford Health System - Henry Ford Hospital
Detroit, Michigan, 48202-2608
United States
Corewell Health - Infectious Disease
Royal Oak, Michigan, 48073
United States
Duke University Hospital - Infectious Diseases
Durham, North Carolina, 27710
United States
University of Cincinnati College of Medicine - Division of Infectious Diseases
Cincinnati, Ohio, 45267
United States
Oregon Health and Science University - Adult Infectious Diseases Clinic
Portland, Oregon, 97239-3098
United States
University of Pittsburgh - Medicine - Infectious Diseases
Pittsburgh, Pennsylvania, 15213-3403
United States
Carilion Roanoke Memorial Hospital
Roanoke, Virginia, 24014
United States

Collaborators and Investigators

Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)

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 Date2025-02-12
Study Completion Date2026-10-30

Study Record Updates

Study Start Date2025-02-12
Study Completion Date2026-10-30

Terms related to this study

Keywords Provided by Researchers

  • AMR
  • Beta-lactam
  • Cefepime
  • cystatin-C
  • eGFR
  • Gram-negative
  • Iohexol
  • Meropenem

Additional Relevant MeSH Terms

  • Bacterial Infection