Acute uncomplicated cholangitis MedDRA version: 9.1 Level: LLT Classification code 10008605 Term: Cholangitis acute
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: - adult age (= 18 years) - acute uncomplicated cholangitis, defined as follows (all 3 criteria must be met): 1. aute febrile disease: (temperatur = 38.0°C at least once in the 24 Stunden prior or after the time point of hospital admission, duration of febrile disease not longer than 7days) 2. Cholestasis documented by at least one imaging technique (sonographie / CT / ERCP / MRCP; maximal diameter of the common bile duct>7 mm, >10 mm for patients with prior cholecystectomy) 3. Obstruction of the common bile duct provenly or probably caused by biliary concrement(s) in the middle or distal third of the common bile duct. - Written informed consent. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range
Exclusion criteria
Exclusion criteria: - Cholangitis, not caused by biliary concrements - Manifested Pankreatitis (not assymptomatic elevation of serum lipase) - Severe sepsis (defined as sepsis with greater or equal of one organfailure or necessary intensive care greater than 24 hours) - Intervention ot the biliary tract (ERCP / PTCD / Operation) in the 14 days prior to hospital admission - Oral antibiotic treatment longer than 48 hours prior to hospital admission - Antibiotic therapy with any other antibiotic than moxifloxacin for longer than 24 hours after hospital admission - Pregnancy, breast-feeding mothers, or women for whom a pregnancy can´t be rouled out - Known intolerance, allergy or contraindication(s) for moxifloxacin or other fluoroquinolones - Advanced liver cirrhosis (Child-Pugh stage C) - Chronic liver diseases with elevation of transaminases above 5-time the upper limit of normal - Terminal renal failure neccessitating dialysis - Life exspectancy below 3 month - Severe immunosuppression (= 20mg prednisolon per day, or any other medical immunosuppression, patients with known HIV–infection, patients with prior transplantations (BMT or solid organ) - Chemotherapy for a malignant disease in the 14 day prior or during the study period - Known epilepsy - Clinical relevant bradykardia (HR continiously < 40/min) - Symptomatic arrhythmias in the medical history (not atrial fibrilation) - Clinical relevant heart insufficiency (leftventricular EF<30%) - Known concgenital or sporadic QTc-Prolongation or concommittant use of medication that prolongs the QTc-interval (e.g. cisapride, antiarrhythmic drugs of the class IA and III like amiodarone, sotalol, disopyramid, chinidine and procainamide) - Disturbancies of serum electrolytes, especially untreated hypokalemia - Tendon-related problems that occured during prior treatment with a fluoroquinolone - Known or suspected additional bacterial infection neccessitating additional systemic antibiotic therapy - Prior participation in this study or participation in any therapeutic study in the 30 days prior to the hospital admission or during the study period
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: Evaluation of the neccessary duration of antibiotic therapy for patients with acute uncomplicated cholangitis.;Secondary Objective: To compare the length oth the actual hospital stay among patients receiving a short or a long course of antibiotic therapy. To compare the mortality, the rate of complications and the rate of relapses among patients receiving a short or a long course of antibiotic therapy. To compare the rate of isolated fluoroquinolone resistant bacteria among patients receiving a short or a long course of antibiotic therapy. To dertermine the clinical course ot patients during the non-randomized i.v. treatment with moxifloxacin. To meassure the biliary concentration of moxifloxacin in specimens obtained during ERCP. ;Primary end point(s): Primary enpoint of the trial is the combined rate of relapses, complications and death in the 28 days following the initial hospital admission. | — |
Countries
Germany