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Study Comparing Tigecycline Versus Ceftriaxone Sodium Plus Metronidazole in Complicated Intra-abdominal Infection (cIAI)

A Multicenter, Open-Label, Randomized Comparative Study of Tigecycline vs Ceftriaxone Sodium Plus Metronidazole for the Treatment of Hospitalized Subjects With Complicated Intra-abdominal Infection

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00230971
Enrollment
473
Registered
2005-10-03
Start date
2005-10-31
Completion date
2008-09-30
Last updated
2013-02-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Appendicitis, Cholecystitis, Diverticulitis, Intra-Abdominal Abscess, Intra-Abdominal Infection, Peritonitis

Keywords

Intra-Abdominal Infections, Abscess

Brief summary

This is a study of the safety and efficacy of tigecycline to ceftriaxone sodium plus metronidazole in hospitalized subjects with cIAI. Subjects will be followed for efficacy through the test-of-cure assessment. Safety evaluations will occur through the treatment and post-treatment periods and continue through resolution or stability of the adverse event(s).

Interventions

DRUGtigecycline

every 12 hours IV (an initial dose of 100 mg followed by 50 mg every 12 hours)

DRUGceftriaxone plus metronidazole

Ceftriaxone sodium 2 g once daily intravenously plus metronidazole 1 g to 2 g daily given in divided doses intravenously. Test article should be administered for a minimum of 4 days and up to 14 days at the discretion of the investigator.

Sponsors

Wyeth is now a wholly owned subsidiary of Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Clinical diagnosis of complicated intra-abdominal infection that requires surgery within 24 hours. * Fever plus other symptoms such as nausea, vomiting, abdominal pain.

Exclusion criteria

* Cancer * Medicines that suppress the immune system * Dialysis

Design outcomes

Primary

MeasureTime frameDescription
Number of Clinically Evaluable (CE) Patients With Clinical Response of Cure at the Test-of-Cure (TOC) Visitup to 6 weeksCE population were those who completed TOC assessment of cure or failure (but not indeterminate) or, in case of premature discontinuation due to lack of efficacy, had completed end of treatment assessment such that assessment of clinical response could be made. Clinical response was assigned by investigator per protocol-specified guidelines and defined as: test article and initial intervention (operative and/or radiologically controlled drainage procedure) resolved the intra-abdominal infection. TOC performed 10-28 days after last dose of study drug.

Secondary

MeasureTime frameDescription
Number of Microbiologically Evaluable (ME) Patients With a Clinical Response of Cure at Test-of-Cure (TOC) Visitup to 6 weeksME population were subjects who were clinically evaluable and had baseline culture with at least 1 identified isolate that was susceptible to study drug and comparator. The clinical response was assigned by the investigator according to the protocol-specified guidelines. A clinical response of cure was defined as: the test article and the initial intervention (operative and/or radiologically controlled drainage procedure) resolved the intra-abdominal infection.
Number of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) Visitup to 6 weeksMicrobiological response was assessed at patient level was the combined responses for all baseline isolates identified in intra-abdominal and blood cultures. Eradication=baseline isolate not recovered from primary infection site/blood; Presumed Eradication=No sample for culture, clinical response was cure; Persistence=baseline isolate recovered from primary infection site/blood; Presumed Persistence=No sample available for culture, clinical response was failure; Superinfection=culture from primary infection site with new isolate not identified at baseline, clinical response was failure.
Number of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-Cureup to 6 weeksHealthcare resource utilization assessment included days of overall inpatient hospitalization, days of primary inpatient hospitalization, days of Intensive Care Unit (ICU) treatment and days of non-ICU inpatient hospitalization

Countries

Australia, China, Denmark, Finland, France, Germany, Greece, Hong Kong, India, Italy, Philippines, Portugal, Saudi Arabia, South Africa, Spain, Switzerland, Taiwan, Turkey (Türkiye), United Kingdom

Participant flow

Recruitment details

Patients were recruited worldwide from November 2005 to July 2008.

Pre-assignment details

Patients were screened according to the inclusion/exclusion criteria. Once informed consent was obtained, the patient was enrolled into the study and assigned a randomization number and a treatment regimen.

Participants by arm

ArmCount
Tigecycline
Tigecycline administered IV every 12 hours (an initial dose of 100 mg followed by 50 mg every 12 hours).
232
Ceftriaxone
Ceftriaxone sodium 2 g administered IV once daily plus metronidazole 1 to 2 g daily in divided IV doses.
235
Total467

Withdrawals & dropouts

PeriodReasonFG000FG001
Baseline ParticipantsAdverse Event10
Baseline ParticipantsDeath65
Baseline ParticipantsFailure to return11
Baseline ParticipantsLost to Follow-up512
Baseline ParticipantsNo bacteria observed10
Baseline ParticipantsReintervention10
Baseline ParticipantsWithdrawal by Subject71
RandomizationNo study drug administered33

Baseline characteristics

CharacteristicTigecyclineCeftriaxoneTotal
Age Continuous48.55 years
STANDARD_DEVIATION 18.37
46.81 years
STANDARD_DEVIATION 18.38
47.67 years
STANDARD_DEVIATION 18.37
Sex: Female, Male
Female
80 Participants72 Participants152 Participants
Sex: Female, Male
Male
152 Participants163 Participants315 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
173 / 232155 / 235
serious
Total, serious adverse events
37 / 23238 / 235

Outcome results

Primary

Number of Clinically Evaluable (CE) Patients With Clinical Response of Cure at the Test-of-Cure (TOC) Visit

CE population were those who completed TOC assessment of cure or failure (but not indeterminate) or, in case of premature discontinuation due to lack of efficacy, had completed end of treatment assessment such that assessment of clinical response could be made. Clinical response was assigned by investigator per protocol-specified guidelines and defined as: test article and initial intervention (operative and/or radiologically controlled drainage procedure) resolved the intra-abdominal infection. TOC performed 10-28 days after last dose of study drug.

Time frame: up to 6 weeks

Population: All patients who received at least 1 dose of study drug who had clinical evidence of a complicated intra-abdominal infection (cIAI) and completed the test-of-cure (TOC) assessment of cure or failure within 8 to 44 days after the last administration of study article. Patients with an indeterminate assessment were excluded.

ArmMeasureValue (NUMBER)
TigecyclineNumber of Clinically Evaluable (CE) Patients With Clinical Response of Cure at the Test-of-Cure (TOC) Visit162 participants
CeftriaxoneNumber of Clinically Evaluable (CE) Patients With Clinical Response of Cure at the Test-of-Cure (TOC) Visit150 participants
95% CI: [-6.4, 9.6]t-test, 1 sided
Secondary

Number of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-Cure

Healthcare resource utilization assessment included days of overall inpatient hospitalization, days of primary inpatient hospitalization, days of Intensive Care Unit (ICU) treatment and days of non-ICU inpatient hospitalization

Time frame: up to 6 weeks

Population: All patients who received at least 1 dose of study drug.

ArmMeasureGroupValue (MEAN)Dispersion
TigecyclineNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CureOverall inpatient hospitalization13.03 daysStandard Deviation 12.45
TigecyclineNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CurePrimary inpatient hospitalization12.62 daysStandard Deviation 12.28
TigecyclineNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CureICU treatment8.24 daysStandard Deviation 9.47
TigecyclineNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CureInpatient hospitalization, non-ICU11.09 daysStandard Deviation 9.21
CeftriaxoneNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CureInpatient hospitalization, non-ICU10.80 daysStandard Deviation 7.93
CeftriaxoneNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CureOverall inpatient hospitalization12.69 daysStandard Deviation 10.25
CeftriaxoneNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CureICU treatment6.14 daysStandard Deviation 8.7
CeftriaxoneNumber of Days of Inpatient Healthcare Resource Utilization on or Before Test-of-CurePrimary inpatient hospitalization12.16 daysStandard Deviation 9.75
Comparison: Overall inpatient hospitalizationp-value: 0.75ANOVA
Comparison: Primary inpatient hospitalizationp-value: 0.655ANOVA
Comparison: ICU treatmentp-value: 0.191ANOVA
Comparison: Inpatient hospitalization, non-ICUp-value: 0.717ANOVA
Secondary

Number of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) Visit

Microbiological response was assessed at patient level was the combined responses for all baseline isolates identified in intra-abdominal and blood cultures. Eradication=baseline isolate not recovered from primary infection site/blood; Presumed Eradication=No sample for culture, clinical response was cure; Persistence=baseline isolate recovered from primary infection site/blood; Presumed Persistence=No sample available for culture, clinical response was failure; Superinfection=culture from primary infection site with new isolate not identified at baseline, clinical response was failure.

Time frame: up to 6 weeks

Population: All patients who received ≥1 dose, had clinical evidence of complicated intra-abdominal infection, met all inclusion/exclusion criteria, completed TOC assessment within 8-44 days after last dose, and had a baseline culture with ≥1 identified isolate that was susceptible to both study drugs. Patients with an indeterminate assessment were excluded.

ArmMeasureGroupValue (NUMBER)
TigecyclineNumber of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) VisitPersistence + Presumed Persistence21 participants
TigecyclineNumber of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) VisitEradication + Presumed Eradication98 participants
TigecyclineNumber of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) VisitSuperinfection3 participants
CeftriaxoneNumber of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) VisitEradication + Presumed Eradication86 participants
CeftriaxoneNumber of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) VisitPersistence + Presumed Persistence22 participants
CeftriaxoneNumber of Microbiologically Evaluable (ME) Patients by Microbiological Response at Test-of-Cure (TOC) VisitSuperinfection0 participants
Comparison: Group comparison of eradication + presumed eradication95% CI: [-7.9, 13.3]t-test, 1 sided
Secondary

Number of Microbiologically Evaluable (ME) Patients With a Clinical Response of Cure at Test-of-Cure (TOC) Visit

ME population were subjects who were clinically evaluable and had baseline culture with at least 1 identified isolate that was susceptible to study drug and comparator. The clinical response was assigned by the investigator according to the protocol-specified guidelines. A clinical response of cure was defined as: the test article and the initial intervention (operative and/or radiologically controlled drainage procedure) resolved the intra-abdominal infection.

Time frame: up to 6 weeks

Population: All patients who received ≥1 dose, had clinical evidence of complicated intra-abdominal infection, met all inclusion/exclusion criteria, completed TOC assessment within 8-44 days after last dose, and had a baseline culture with ≥1 identified isolate that was susceptible to both study drugs. Patients with an indeterminate assessment were excluded.

ArmMeasureValue (NUMBER)
TigecyclineNumber of Microbiologically Evaluable (ME) Patients With a Clinical Response of Cure at Test-of-Cure (TOC) Visit97 participants
CeftriaxoneNumber of Microbiologically Evaluable (ME) Patients With a Clinical Response of Cure at Test-of-Cure (TOC) Visit86 participants
p-value: 0.00195% CI: [-8.8, 12.5]t-test, 1 sided

Source: ClinicalTrials.gov · Data processed: Mar 26, 2026