A Study to Assess the Safety, Tolerability, and Pharmacokinetics of Single and Multiple Doses of Cefiderocol in Hospitalized Pediatric Participants

Last updated: January 22, 2024
Sponsor: Shionogi
Overall Status: Completed

Phase

2

Condition

Bacterial Infections

Soft Tissue Infections

Urinary Tract Infections

Treatment

Cefiderocol

Standard of Care

Clinical Study ID

NCT04335539
1802R2135
2019-002120-32
  • Ages 3-17
  • All Genders

Study Summary

The primary objectives of this study are:

  • To assess the safety and tolerability of cefiderocol after single-dose administration in hospitalized paediatric participants 3 months to < 18 years of age with suspected or confirmed aerobic Gram-negative bacterial infections

  • To assess the pharmacokinetics (PK) of cefiderocol after single-dose administration of cefiderocol in hospitalized paediatric participants 3 months to < 18 years of age with suspected or confirmed aerobic Gram-negative bacterial infections

  • To assess the safety and tolerability of cefiderocol after multiple-dose administration in hospitalized paediatric participants 3 months to < 12 years of age with suspected or confirmed aerobic Gram-negative bacterial infections

  • To assess the PK of cefiderocol after multiple-dose administration in hospitalized paediatric participants 3 months to < 12 years of age with suspected or confirmed aerobic Gram-negative bacterial infections

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Participant's parent(s) or legally authorized representative (LAR) provides writteninformed consent in accordance with regional and country-specific laws andregulations.
  2. Participant provides written informed assent, when feasible (age of assent to bedetermined by institutional review boards/independent ethics committees [IRB's/IEC's]or be consistent with local legal requirements).
  3. Hospitalized participant is 3 months to <18 years of age at the time written informedconsent/assent is obtained for the single-dose phase. Hospitalized participant is 3months to <12 years of age at the time written informed consent/assent is obtained forthe multiple-dose phase. Premature babies will not be restricted, but the participantmust have an adjusted or postnatal age of 3 months.
  4. Participant has a suspected or confirmed infection (including but not limited tocomplicated urinary tract infection [cUTI], complicated intra-abdominal infection [cIAI], hospital-acquired pneumonia [HAP] /ventilator-acquired pneumonia [VAP],sepsis, or bloodstream infections [BSI]) that requires hospitalization for treatmentwith IV antibiotics.
  5. If participant is a sexually active female of childbearing potential and has reachedmenarche or Tanner stage 3, participant agrees to use barrier contraception (includingcondom, diaphragm, or cervical cap) with spermicide or agrees to use a highlyeffective method of contraception (including contraceptive implant, injectablecontraceptive, combination oral contraceptive, or an intrauterine [IUD] contraceptivedevice) from Screening up to 28 days after administration of the last dose ofcefiderocol.

Exclusion

Exclusion Criteria:

  1. Participant has a documented history of any hypersensitivity or allergic reaction toany β-lactam antibiotic (Note: for β-lactams, a history of a mild rash followed byuneventful re-exposure is not a contraindication to enrollment).
  2. Multiple-dose only: Participant has an infection caused only by a confirmedGram-positive pathogen.
  3. Participant has a suspected or confirmed central nervous system (CNS) infection (eg,meningitis, brain abscess, shunt infection) or osteomyelitis (which would requireprolonged antibiotic therapy).
  4. Participant has cystic fibrosis.
  5. Single-dose phase: Participant has moderate or severe renal impairment based onestimated glomerular filtration rate (eGFR) (based on Schwartz equation if ≥ 3 monthsto < 1 year of age and modified Bedside Schwartz equation if ≥ 1 to < 18 years of age)of < 60 milliliter (mL) per minute (min)/1.73 ^2² at Screening. Multiple-dose phase: Participant has an eGFR (based on Schwartz equation if ≥ 3 monthsto < 1 year of age and modified Bedside Schwartz equation if ≥ 1 to < 18 years of age)of < 15 mL/min/1.73 ^2² at Screening.
  6. Participant has end-stage renal disease (ESRD), is on hemodialysis (HD), or receivingcontinuous venovenous hemofiltration (CVVH).
  7. Participant has experienced shock in the prior month or is in shock at the time ofScreening.
  8. Participant has severe neutropenia or is severely immunocompromised.
  9. Participant has multiorgan failure.
  10. Participant has a life expectancy of < 30 days due to severity of a concurrentillness.
  11. Participant is a female who has a positive pregnancy test at Screening.
  12. Participant is a female who is breastfeeding.
  13. Participant has received any other investigational medicinal product (IMP) within 30days.
  14. Participant has any condition or circumstance that, in the opinion of theinvestigator, would compromise the safety of the participant or the quality of thestudy data, including acute trauma to the pelvis or urinary tract.
  15. Participant is receiving vasopressor therapy at Screening.

Study Design

Total Participants: 54
Treatment Group(s): 2
Primary Treatment: Cefiderocol
Phase: 2
Study Start date:
August 21, 2020
Estimated Completion Date:
February 06, 2023

Study Description

This is a multicenter, single-arm, open-label, single- and multiple-dose study to assess the safety, tolerability, and PK of cefiderocol in hospitalized paediatric participants.

The single-dose phase will include 4 separate cohorts of participants, grouped according to age range:

  • Cohort 1: 12 to < 18 years

  • Cohort 2: 6 to < 12 years

  • Cohort 3: 2 to < 6 years

  • Cohort 4: 3 months to < 2 years Cohorts 1, 2, and 3 in the single-dose phase will be initiated in parallel. Cohort 4 will begin after safety and PK data from at least 6 participants from the single-dose Cohorts 1, 2, and 3 (with a minimum of 3 participants from Cohort 3) have been assessed.

The multiple-dose phase will include 3 cohorts according to age range (Cohorts 2, 3, and 4) and will begin after safety and PK data from 6 participants in the corresponding single-dose cohort have been assessed.

Connect with a study center

  • Cliniques Universitaires Saint-Luc

    Brussels,
    Belgium

    Site Not Available

  • Universitair Ziekenhuis Brussel

    Brussels, 1200
    Belgium

    Site Not Available

  • Tallinn Childrens Hospital

    Tallin,
    Estonia

    Site Not Available

  • Tartu Ulikooli Kliinikum - Anestesioloogia ja Intensiivravi Kliinik

    Tartu,
    Estonia

    Site Not Available

  • JSC "Medical Corporation Evex" " M. Iashvili Batumi Maternal and Child Central Hospital"

    Batumi,
    Georgia

    Site Not Available

  • JSC "EVEX Medical Corporation"- M Lashvili Childrens Central Hospital

    Tbilisi,
    Georgia

    Site Not Available

  • Ltd Unimedi Kakheti Childrens New Clinic

    Tbilisi,
    Georgia

    Site Not Available

  • Heim Pl Orszgos Gyermekgygyszati Intzet

    Pilisborosjenő,
    Hungary

    Site Not Available

  • Szegedi Tudomnyegyetem

    Szegedi Tudomnyegyetem,
    Hungary

    Site Not Available

  • Daugavpils regional Hospital

    Daugavpils,
    Latvia

    Site Not Available

  • Bernu Kliniska Universitates Slimnica Childrens Hospital - Tornakalna

    Riga,
    Latvia

    Site Not Available

  • St.Petersburg State Pediatric Medical University

    Saint Petersburg,
    Russian Federation

    Site Not Available

  • Smolensk State Medical University

    Smolensk,
    Russian Federation

    Site Not Available

  • St. Petersburg State Pediatric Medical University

    St. Petersburg,
    Russian Federation

    Site Not Available

  • Hospital Germans Trias i Pujol

    Barcelona,
    Spain

    Site Not Available

  • Hospital Universitario y Politecnico La Fe

    Valencia,
    Spain

    Site Not Available

  • King Chulalongkorn Memorial Hospital, Chulalongkorn University

    Bangkok,
    Thailand

    Site Not Available

  • Siriraj Hospital

    Bangkok-noi,
    Thailand

    Site Not Available

  • PHPT-Chiangrai PrachanuKroh Hospital

    Chiang Mai,
    Thailand

    Site Not Available

  • Khon Kaen University (KKU) - Faculty of Medicine-Srinagarind Hospital

    Khon Kaen,
    Thailand

    Site Not Available

  • Dnipropetrovsk Regional Children Clinical Hospital

    Kharkiv,
    Ukraine

    Site Not Available

  • Regional Children Clinical Hospital

    Kharkiv,
    Ukraine

    Site Not Available

  • National Childrens Specialized Hospital OHMATDYT of the Ministry of Health of Ukraine

    Kiev,
    Ukraine

    Site Not Available

  • Higher State Educational Institute of Ukraine Ukrainian Medical Stamatological Academy

    Poltava,
    Ukraine

    Site Not Available

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