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Pharmacokinetics (PK) Study of a Fluconazole Loading Dose in Infants and Toddlers
This study is enrolling participants by invitation only.
Sponsors and Collaborators: Duke University
Pediatric Pharmacology Research Unit Network
Information provided by: Duke University
ClinicalTrials.gov Identifier: NCT00797420
  Purpose

The purpose of this study is to investigate the pharmacokinetics and safety of a fluconazole loading dose in infants and toddlers.


Condition Intervention Phase
Candidiasis
Drug: Fluconazole Loading Dose
Drug: Fluconazole Loading Dose & High Dose
Phase I

MedlinePlus related topics: Yeast Infections
Drug Information available for: Clotrimazole Miconazole Miconazole nitrate Tioconazole Fluconazole
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Dose Comparison, Parallel Assignment, Pharmacokinetics Study
Official Title: Pharmacokinetics of a Fluconazole Loading Dose in Infants and Toddlers

Further study details as provided by Duke University:

Primary Outcome Measures:
  • Plasma concentration of Fluconazole [ Time Frame: 6-8 samples over 5 days ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 48
Study Start Date: November 2008
Estimated Study Completion Date: January 2010
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Loading Dose
Loading Dose
Drug: Fluconazole Loading Dose
Single Fluconazole loading dose 25 mg/kg
Loading & high dose
Loading dose & high dose Fluconazole
Drug: Fluconazole Loading Dose & High Dose
Fluconazole loading dose 25 mg/kg, followed by fluconazole 12 mg/kg q24 hours for total of 5 days

Detailed Description:

This is an open label study to investigative the pharmacokinetics and safety of a fluconazole loading dose in infants and toddlers < 2 years of age with suspected sepsis. There will be two treatment groups: single fluconazole loading dose 25 mg/kg; fluconazole loading dose 25mg/kg followed by 12 mg/kg daily for total of 5 days. There will be three age cohorts within each group: pre-term < 30 week EGA infants > 48 hours and < 31 days; > 30 weeks EGA infants > 48 hours and < 31 days; infants ≥ 31 days and < 2 years of age. The study requires administration of fluconazole over 1-5 days depending on treatment group followed by 1 week of safety monitoring. Six to eight 100 µL PK samples will be obtained over the 5 days of drug administration. The risks are reasonable vs. the benefits and have been minimized appropriately. There may be benefit to the subjects (administration of empirical antifungal therapy), and information from the study may benefit a large number of other infants and toddlers with suspected or proven fungal sepsis. There is a data analysis plan.

  Eligibility

Ages Eligible for Study:   up to 2 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • suspected sepsis with blood culture within 48 hours
  • age ≥ 48 hours and < 2 years of age
  • sufficient venous access to permit study drug administration

Exclusion Criteria:

  • allergic reaction to azole
  • history of fluconazole administration in prior 5 days
  • liver dysfunction
  • renal failure
  • concomitant use of cyclosporine, tacrolimus, or azithromycin
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00797420

Locations
United States, North Carolina
Duke Univeristy Medical Center
Durham, North Carolina, United States, 27715
Sponsors and Collaborators
Duke University
Pediatric Pharmacology Research Unit Network
Investigators
Principal Investigator: Lauren Piper, MD Duke University
  More Information

Publications:
Benjamin DK Jr, Stoll BJ. Infection in late preterm infants. Clin Perinatol. 2006 Dec;33(4):871-82; abstract x. Review.
Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, Lemons JA, Donovan EF, Stark AR, Tyson JE, Oh W, Bauer CR, Korones SB, Shankaran S, Laptook AR, Stevenson DK, Papile LA, Poole WK. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002 Aug;110(2 Pt 1):285-91.
Benjamin DK Jr, DeLong ER, Steinbach WJ, Cotton CM, Walsh TJ, Clark RH. Empirical therapy for neonatal candidemia in very low birth weight infants. Pediatrics. 2003 Sep;112(3 Pt 1):543-7.
Novelli V, Holzel H. Safety and tolerability of fluconazole in children. Antimicrob Agents Chemother. 1999 Aug;43(8):1955-60.
Brammer KW, Coates PE. Pharmacokinetics of fluconazole in pediatric patients. Eur J Clin Microbiol Infect Dis. 1994 Apr;13(4):325-9.
Wade KC, Wu D, Kaufman DA, Ward RM, Benjamin DK Jr, Sullivan JE, Ramey N, Jayaraman B, Hoppu K, Adamson PC, Gastonguay MR, Barrett JS; National Institute of Child Health and Development Pediatric Pharmacology Research Unit Network. Population pharmacokinetics of fluconazole in young infants. Antimicrob Agents Chemother. 2008 Nov;52(11):4043-9. Epub 2008 Sep 22.
Anaissie EJ, Kontoyiannis DP, Huls C, Vartivarian SE, Karl C, Prince RA, Bosso J, Bodey GP. Safety, plasma concentrations, and efficacy of high-dose fluconazole in invasive mold infections. J Infect Dis. 1995 Aug;172(2):599-602.

Responsible Party: Duke Univeristy Medical Center ( Danny K. Benjamin MD, PhD, MPH )
Study ID Numbers: 11454, NIH-5U10-HD-045962-04
Study First Received: November 23, 2008
Last Updated: November 24, 2008
ClinicalTrials.gov Identifier: NCT00797420  
Health Authority: United States: Food and Drug Administration

Keywords provided by Duke University:
fluconazole
pharmacokinetic
candidiasis
sepsis
pediatric
infants
antifungal
candidemia
fungemia
loading dose

Study placed in the following topic categories:
Fluconazole
Mycoses
Sepsis
Candidiasis
Clotrimazole
Miconazole
Tioconazole
Fungemia

Additional relevant MeSH terms:
Anti-Infective Agents
Therapeutic Uses
Antifungal Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009