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Clarithromycin Modified Release Observational Study for Evaluation of Treatment, Tolerability & Recovery Time in Saudi & Egyptian Clinical Settings (CLOSER)

Clarithromycin Modified Release Observational Study for Evaluation of Treatment, Tolerability & Recovery Time in Saudi & Egyptian Clinical Settings (CLOSER)

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT01075204
Acronym
CLOSER
Enrollment
335
Registered
2010-02-25
Start date
2011-01-31
Completion date
2012-01-31
Last updated
2013-02-12

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

Conditions

Respiratory Tract Infection

Keywords

Respiratory Tract Infection, Clarithromycin, Recovery

Brief summary

The objective is to describe the time to recovery of symptoms (cough, mucus, fever, sore throat, and others), tolerability and compliance of treatment with clarithromycin once daily in patients with upper or lower respiratory tract infections in the routine clinical practice.

Interventions

clarithromycin modified release 500 mg for 7 days

Sponsors

Eilaf
CollaboratorOTHER
Abbott
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

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

Inclusion criteria

* Adults, equal to or more than 18 years years of age * Patients with respiratory tract infections, including any of the following: * Acute tracheitis, acute tracheobronchitis * Acute sinusitis * Chronic sinusitis * Acute tonsillopharyngitis * Acute bronchitis * Mild community-acquired pneumonia * Acute exacerbation of chronic bronchitis

Exclusion criteria

* Known hypersensitivity to or previously intolerant of macrolides. * Illness severe enough to warrant hospitalization or parenteral therapy. * Concomitant use of any of the following medications: * Drugs metabolized by CYP3A isozyme: alprazolam, astemizole, carbamazepine, cilostazol, cisapride, cyclosporin, disopyramide, ergot alkaloids, lovastatin, methylprednisolone, midazolam, omeprazole, oral anticoagulants (e.g. warfarin), pimozide, quinidine, rifabutin, sildenafil, simvastatin, tacrolimus, terfenadine, triazolam and vinblastine. * Drugs metabolized by other isozymes within CYP450 system: phenytoin, theophylline and valproate. * Colchicine, Digoxin, Some antiretrovirals: zidovudine and ritonavir. * Severe immunodeficiency and chronic disease conditions. * Renal or hepatic impairment (creatinine clearance under 30 mL/min, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) equal or more than 3x higher level in comparison with the norm). * Mental condition rendering the subject unable to understand the nature of the study.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With a Fast RecoveryDay 1 to Day 5Fast recovery is defined as the resolution of symptoms within 5 days or less from the start of clarithromycin modified release treatment. Recovery is defined as returning to the symptom status prior to the onset of the respiratory tract infection, based on the participant and physician's assessment. Data are reported for all symptoms taken together (all symptoms resolved within 5 days) and for each individual symptom.
Percentage of Participants With Clinical Success10 daysClinical success is defined as the disappearance of cough and other symptoms within 10 days or less from the start of clarithromycin treatment.
Classification of Overall Response10 daysBased on the participant and physician's assessment, overall symptom response was classified as follows: * Fast Responders: participants showing clinical recovery of all symptoms within the first 5 days of treatment. * Slow Responders: participants showing clinical recovery between Day 6 & Day 10 (includes participants with a fast response for some symptoms and slow response for the remaining symptoms). * Failure response: participants showing no clinical success by Day 10, or showing need for another anti-infective treatment to resolve aggravated symptoms (includes participants with a failure response for some symptoms and either a slow or fast response for the remaining symptoms).

Secondary

MeasureTime frameDescription
Fever Status at End of Study10 daysParticipants with fever (temperature over 37.0 degree of Celsius) at any time during the study were classified at the end of study as resolved, improved or no change. 'No fever' indicates participants with no fever during the study period.
Cough Status at End of Study10 daysParticipants with cough at any time during the study were classified at the end of study as resolved, improved, became worse, or no change. 'No cough' indicates participants with no cough symptoms during the study period.
Sputum Status at End of Study10 daysParticipants with sputum symptoms at any time during the study were classified at the end of study as resolved, improved, became worse, or no change. 'No sputum' indicates participants with no sputum symptoms during the study period.
Dyspnea Status at End of Study10 daysParticipants with dyspnea (shortness of breath) at any time during the study were classified at the end of study as resolved, improved, became worse, or no change. 'No dyspnea' indicates participants with no dyspnea symptoms during the study period.
Percentage of Participants With Treatment Failure10 daysTreatment failure is defined as failure to return to baseline symptom status (symptom status prior to the onset of the respiratory tract infection) within 10 days or the need for new treatments or medications during the first 10 days for persistence or aggravation of symptoms. Participants with treatment failure were further categorized as: * All symptoms improved but not resolved within the study period; * Some symptoms improved and some resolved; * Some symptoms resolved or improved while other symptoms did not improve (unchanged); * Some symptoms resolved or improved while other symptoms became worse.
Rhinorrhea Status at End of Study10 daysParticipants with rhinorrhea (runny nose) at any time during the study were classified at the end of study as resolved, or no change. 'No rhinorrhea' indicates participants with no rhinorrhea during the study period.
Post-nasal Discharge Status at End of Study10 daysParticipants with post-nasal discharge at any time during the study were classified at the end of study as resolved, improved, or no change. 'No post-nasal discharge' indicates participants with no post-nasal discharge symptoms during the study period.
Percentage of Participants Compliant With Treatment10 daysTreatment compliance was assessed by the study physician at each study visit. The percentage of participants who were compliant with study treatment for 6 days, 7 days and 8 days is reported.
Abnormal Breathing Sounds Status at End of Study10 daysParticipants with abnormal breathing sounds such as wheezing or rales at any time during the study were classified at the end of study as resolved, improved, or no change. 'No abnormal breath sounds' indicates participants with no abnormal breathing sounds during the study period.
Factors Affecting the Speed of Recovery10 daysFactors affecting the speed of recovery were examined and tested for association with the speed of recovery. Logistic regression was conducted to assess whether the following nine variables; age, gender, body mass index (BMI), concomitant tobacco use, steroid use, bronchial asthma, allergic rhinitis, nasal septum deviation and chronic obstructive pulmonary disease (COPD) act as predictors for speed of recovery of respiratory tract infections. Data shown are the beta regression coefficients for each variable.
Number of Participants With Adverse Events10 daysAn adverse event (AE) is defined as any untoward medical occurrence in a patient, which does not necessarily have a causal relationship with their treatment. If an adverse event meets any of the following criteria, it is considered a serious adverse event (SAE): Results in death or is life-threatening, results in admission or prolongation of hospitalization, is a congenital anomaly or persistent or significant disability/incapacity or is an important medical event requiring medical or surgical intervention to prevent any of the outcomes listed above. Please see Adverse Events section below for more details.

Countries

Egypt, Saudi Arabia

Participant flow

Participants by arm

ArmCount
Clarithromycin Modified Release
Participants with upper or lower respiratory tract infection were administered clarithromycin modified release 500 mg once daily for 7 days and then followed for a further 3 days, per routine clinical practice.
335
Total335

Baseline characteristics

CharacteristicClarithromycin Modified Release
Age Continuous35.48 years
STANDARD_DEVIATION 12.552
Region of Enrollment
Egypt
120 participants
Region of Enrollment
Saudi Arabia
215 participants
Sex/Gender, Customized
Female
122 participants
Sex/Gender, Customized
Male
205 participants
Sex/Gender, Customized
Missing
8 participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
2 / 335
serious
Total, serious adverse events
0 / 335

Outcome results

Primary

Classification of Overall Response

Based on the participant and physician's assessment, overall symptom response was classified as follows: * Fast Responders: participants showing clinical recovery of all symptoms within the first 5 days of treatment. * Slow Responders: participants showing clinical recovery between Day 6 & Day 10 (includes participants with a fast response for some symptoms and slow response for the remaining symptoms). * Failure response: participants showing no clinical success by Day 10, or showing need for another anti-infective treatment to resolve aggravated symptoms (includes participants with a failure response for some symptoms and either a slow or fast response for the remaining symptoms).

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseClassification of Overall ResponseFast responders43 participants
Clarithromycin Modified ReleaseClassification of Overall ResponseSlow responders248 participants
Clarithromycin Modified ReleaseClassification of Overall ResponseFailure response44 participants
Primary

Percentage of Participants With a Fast Recovery

Fast recovery is defined as the resolution of symptoms within 5 days or less from the start of clarithromycin modified release treatment. Recovery is defined as returning to the symptom status prior to the onset of the respiratory tract infection, based on the participant and physician's assessment. Data are reported for all symptoms taken together (all symptoms resolved within 5 days) and for each individual symptom.

Time frame: Day 1 to Day 5

Population: All enrolled participants. For the individual symptoms, N indicates the number of participants with that symptom at Baseline and with available recovery data.

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryCough response [N=215]27.4 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoverySputum response [N=212]29.7 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryAll symptoms together [N=335]12.8 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryFever response [N=184]54.3 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryDyspnea response [N=62]37.1 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryAbnormal breath sounds response [N=47]42.6 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryRhinorrhea response [N=113]28.3 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryNasal congestion response [N=233]33.5 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryPost-nasal discharge response [N=178]18.5 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoverySneezing response [N=87]25.3 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoverySore throat response [N=200]38.0 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryPainful swallowing response [N=162]38.9 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryItchy watery eye response [N=33]6.1 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryMalaise response [N=68]30.9 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With a Fast RecoveryMyalgia response [N=79]34.2 percentage of participants
Primary

Percentage of Participants With Clinical Success

Clinical success is defined as the disappearance of cough and other symptoms within 10 days or less from the start of clarithromycin treatment.

Time frame: 10 days

Population: All enrolled patients.

ArmMeasureValue (NUMBER)
Clarithromycin Modified ReleasePercentage of Participants With Clinical Success86.9 percentage of participants
Secondary

Abnormal Breathing Sounds Status at End of Study

Participants with abnormal breathing sounds such as wheezing or rales at any time during the study were classified at the end of study as resolved, improved, or no change. 'No abnormal breath sounds' indicates participants with no abnormal breathing sounds during the study period.

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseAbnormal Breathing Sounds Status at End of StudyResolved30 participants
Clarithromycin Modified ReleaseAbnormal Breathing Sounds Status at End of StudyImproved13 participants
Clarithromycin Modified ReleaseAbnormal Breathing Sounds Status at End of StudyNo change4 participants
Clarithromycin Modified ReleaseAbnormal Breathing Sounds Status at End of StudyNo abnormal breath sounds288 participants
Secondary

Cough Status at End of Study

Participants with cough at any time during the study were classified at the end of study as resolved, improved, became worse, or no change. 'No cough' indicates participants with no cough symptoms during the study period.

Time frame: 10 days

Population: Enrolled patients with cough data available.

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseCough Status at End of StudyResolved93 participants
Clarithromycin Modified ReleaseCough Status at End of StudyImproved100 participants
Clarithromycin Modified ReleaseCough Status at End of StudyNo change23 participants
Clarithromycin Modified ReleaseCough Status at End of StudyWorsened4 participants
Clarithromycin Modified ReleaseCough Status at End of StudyNo cough113 participants
Secondary

Dyspnea Status at End of Study

Participants with dyspnea (shortness of breath) at any time during the study were classified at the end of study as resolved, improved, became worse, or no change. 'No dyspnea' indicates participants with no dyspnea symptoms during the study period.

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseDyspnea Status at End of StudyResolved31 participants
Clarithromycin Modified ReleaseDyspnea Status at End of StudyImproved28 participants
Clarithromycin Modified ReleaseDyspnea Status at End of StudyNo change2 participants
Clarithromycin Modified ReleaseDyspnea Status at End of StudyWorsened1 participants
Clarithromycin Modified ReleaseDyspnea Status at End of StudyNo dyspnea273 participants
Secondary

Factors Affecting the Speed of Recovery

Factors affecting the speed of recovery were examined and tested for association with the speed of recovery. Logistic regression was conducted to assess whether the following nine variables; age, gender, body mass index (BMI), concomitant tobacco use, steroid use, bronchial asthma, allergic rhinitis, nasal septum deviation and chronic obstructive pulmonary disease (COPD) act as predictors for speed of recovery of respiratory tract infections. Data shown are the beta regression coefficients for each variable.

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryTobacco use0.419 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryBody mass index (BMI)0.004 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryAge-0.007 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryGender0.216 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoverySteroid use-0.456 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryBronchial asthma0.140 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryAllergic rhinitis19.292 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryNasal septum deviation18.698 coefficient
Clarithromycin Modified ReleaseFactors Affecting the Speed of RecoveryChronic obstructive pulmonary disease (COPD)19.281 coefficient
Comparison: Logistic regression: Omnibus Test of Model Coefficients (all the nine variables are considered together).p-value: 0.334Chi-squared
Secondary

Fever Status at End of Study

Participants with fever (temperature over 37.0 degree of Celsius) at any time during the study were classified at the end of study as resolved, improved or no change. 'No fever' indicates participants with no fever during the study period.

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseFever Status at End of StudyResolved120 participants
Clarithromycin Modified ReleaseFever Status at End of StudyImproved70 participants
Clarithromycin Modified ReleaseFever Status at End of StudyNo change5 participants
Clarithromycin Modified ReleaseFever Status at End of StudyNo fever140 participants
Secondary

Number of Participants With Adverse Events

An adverse event (AE) is defined as any untoward medical occurrence in a patient, which does not necessarily have a causal relationship with their treatment. If an adverse event meets any of the following criteria, it is considered a serious adverse event (SAE): Results in death or is life-threatening, results in admission or prolongation of hospitalization, is a congenital anomaly or persistent or significant disability/incapacity or is an important medical event requiring medical or surgical intervention to prevent any of the outcomes listed above. Please see Adverse Events section below for more details.

Time frame: 10 days

Population: All enrolled patients.

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseNumber of Participants With Adverse EventsSerious adverse event0 participants
Clarithromycin Modified ReleaseNumber of Participants With Adverse EventsAny adverse event2 participants
Secondary

Percentage of Participants Compliant With Treatment

Treatment compliance was assessed by the study physician at each study visit. The percentage of participants who were compliant with study treatment for 6 days, 7 days and 8 days is reported.

Time frame: 10 days

Population: All enrolled patients.

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleasePercentage of Participants Compliant With Treatment6 days43 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants Compliant With Treatment7 days54 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants Compliant With Treatment8 days3 percentage of participants
Secondary

Percentage of Participants With Treatment Failure

Treatment failure is defined as failure to return to baseline symptom status (symptom status prior to the onset of the respiratory tract infection) within 10 days or the need for new treatments or medications during the first 10 days for persistence or aggravation of symptoms. Participants with treatment failure were further categorized as: * All symptoms improved but not resolved within the study period; * Some symptoms improved and some resolved; * Some symptoms resolved or improved while other symptoms did not improve (unchanged); * Some symptoms resolved or improved while other symptoms became worse.

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleasePercentage of Participants With Treatment FailureTreatment failure total13.1 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With Treatment FailureAll symptoms improved but not resolved0.9 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With Treatment FailureSome symptoms improved and some resolved3.9 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With Treatment FailureSome symptoms resolved/improved, others unchanged6.9 percentage of participants
Clarithromycin Modified ReleasePercentage of Participants With Treatment FailureSome symptoms resolved/improved/others worsened1.5 percentage of participants
Secondary

Post-nasal Discharge Status at End of Study

Participants with post-nasal discharge at any time during the study were classified at the end of study as resolved, improved, or no change. 'No post-nasal discharge' indicates participants with no post-nasal discharge symptoms during the study period.

Time frame: 10 days

Population: Enrolled patients with post-nasal discharge data available.

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleasePost-nasal Discharge Status at End of StudyNo change6 participants
Clarithromycin Modified ReleasePost-nasal Discharge Status at End of StudyNo post-nasal discharge154 participants
Clarithromycin Modified ReleasePost-nasal Discharge Status at End of StudyResolved75 participants
Clarithromycin Modified ReleasePost-nasal Discharge Status at End of StudyImproved98 participants
Secondary

Rhinorrhea Status at End of Study

Participants with rhinorrhea (runny nose) at any time during the study were classified at the end of study as resolved, or no change. 'No rhinorrhea' indicates participants with no rhinorrhea during the study period.

Time frame: 10 days

Population: All enrolled patients

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseRhinorrhea Status at End of StudyResolved55 participants
Clarithromycin Modified ReleaseRhinorrhea Status at End of StudyImproved56 participants
Clarithromycin Modified ReleaseRhinorrhea Status at End of StudyNo change2 participants
Clarithromycin Modified ReleaseRhinorrhea Status at End of StudyNo rhinorrhea222 participants
Secondary

Sputum Status at End of Study

Participants with sputum symptoms at any time during the study were classified at the end of study as resolved, improved, became worse, or no change. 'No sputum' indicates participants with no sputum symptoms during the study period.

Time frame: 10 days

Population: Enrolled patients with sputum data available.

ArmMeasureGroupValue (NUMBER)
Clarithromycin Modified ReleaseSputum Status at End of StudyResolved88 participants
Clarithromycin Modified ReleaseSputum Status at End of StudyImproved102 participants
Clarithromycin Modified ReleaseSputum Status at End of StudyNo change19 participants
Clarithromycin Modified ReleaseSputum Status at End of StudyWorsened4 participants
Clarithromycin Modified ReleaseSputum Status at End of StudyNo sputum120 participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026