Clinical trial • Phase II • Infectious Disease

Aztreonam, Avibactam sodium for Sepsis | Gram-negative bacterial infections | Complicated urinary tract infection | Bloodstream infection | Hospital-acquired pneumonia | Ventilator-associated pneumonia | Complicated intra-abdominal infection

Phase II trial of Aztreonam, Avibactam sodium for Sepsis | Gram-negative bacterial infections | Complicated urinary tract infection | Bloodstream infectio…

Overview

Trial Therapeutic Area
Infectious Disease
Trial Disease
Sepsis | Gram-negative bacterial infections | Complicated urinary tract infection | Bloodstream infection | Hospital-acquired pneumonia | Ventilator-associated pneumonia | Complicated intra-abdominal infection
Trial Stage
Phase II
Drug Modality
Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
20-12-2024
First CTIS Authorization Date
30-04-2025

Trial design

open-label, atm-avi: iv atm-avi loading dose according to weight and age; part b maintenance doses described as q6h or q8h according to age for a minimum of 3 days and maximum of 14 days. atm-avi + mtz: participants in part b with ciai will receive iv atm-avi plus metronidazole; for other infections mtz will be given at investigator discretion if anaerobes are suspected or confirmed.-controlled Phase II trial across 27 sites in Italy, Hungary, Greece and others.

Open Label
Yes
Comparator
ATM-AVI: IV ATM-AVI loading dose according to weight and age; Part B maintenance doses described as q6h or q8h according to age for a minimum of 3 days and maximum of 14 days. ATM-AVI + MTZ: Participants in Part B with cIAI will receive IV ATM-AVI plus metronidazole; for other infections MTZ will be given at investigator discretion if anaerobes are suspected or confirmed.
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
26
Trial Duration For Participant
49

Eligibility

Recruits 26 paediatric patients.

Vulnerable Population
Participants are neonates and infants from birth to <9 months (vulnerable population). Informed consent materials and pediatric informed consent/ICD documents are provided (parent/legal representative consent is required); assent is not applicable for the enrolled age group.

Inclusion criteria

  • {"criterion_text":"- Hospitalized with age from birth <9 months, including preterm birth"}
  • {"criterion_text":"- Part A: Receiving IV antibiotics for treatment of suspected or confirmed bacterial infection, including but not limited to cIAI, cUTI, HAP/VAP, BSI, or sepsis."}
  • {"criterion_text":"- Part B: Suspected or confirmed gram-negative bacterial infection requiring IV antibiotics, including but not limited to cIAI, cUTI, HAP/VAP, BSI, or sepsis."}

Exclusion criteria

  • {"criterion_text":"- Received any other investigational medicinal product within the longer of 30 days or 5 half-lives before enrollment."}
  • {"criterion_text":"- Any medical or laboratory abnormality that may increase the risk of study participation or, in the investigator’s judgment, make the participant inappropriate for the study."}
  • {"criterion_text":"- Severe renal impairment or known significant renal disease, as evidenced by elevated serum creatinine at screening, or urinary output <0.5 mL/kg/h for 6 consecutive hours or requirement for dialysis."}
  • {"criterion_text":"- Part B Only: Received >24 hours of systemic antibiotic treatment for gram-negative organisms at time of enrollment, unless documented treatment failure or lack of improvement in at least one objective sign or symptom of infection after ≥48 hours of antibiotics."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- PK parameters including clearance (CL), maximum plasma concentration (Cmax), area under the plasma concentration time curve (AUC) and half-life (t1/2)","definition_or_measurement_approach":"Pharmacokinetic parameters measured from plasma samples (clearance, Cmax, AUC, t1/2)."}
  • {"endpoint_text":"- Plasma concentrations of ATM and AVI on Day 1 and at steady state (Day 2 or later)","definition_or_measurement_approach":"Measurement of plasma concentrations of aztreonam (ATM) and avibactam (AVI) on Day 1 and at steady state (Day 2 or later)."}
  • {"endpoint_text":"- Adverse events (AEs) and Serious Adverse Events (SAEs)","definition_or_measurement_approach":"Recording and reporting of AEs and SAEs per standard safety assessment procedures."}
  • {"endpoint_text":"- Adverse events leading to discontinuation and adverse events resulting in death","definition_or_measurement_approach":"Capture of AEs leading to study treatment discontinuation and AEs resulting in death."}
  • {"endpoint_text":"- Assessments of liver and renal functions tests at baseline, while on treatment and after end of treatment","definition_or_measurement_approach":"Laboratory assessments of liver and renal function at baseline, during treatment and after end of treatment."}

Secondary endpoints

  • {"endpoint_text":"- Clinical outcomes at End of Intravenous Treatment (EOIV), End of Treatment (EOT), and Test of Cure (TOC). (Pat B only)","definition_or_measurement_approach":"Assessment of clinical outcomes at EOIV, EOT and TOC timepoints (Part B participants)."}
  • {"endpoint_text":"- Per-pathogen microbiological response at EOIV/EOT, and TOC.","definition_or_measurement_approach":"Microbiological response assessed per pathogen at EOIV/EOT and TOC."}
  • {"endpoint_text":"- Per-participant microbiological response at TOC","definition_or_measurement_approach":"Microbiological response assessed per participant at TOC."}
  • {"endpoint_text":"- Emergent infection","definition_or_measurement_approach":"Recording of emergent infections during study treatment and follow-up."}

Recruitment

Planned Sample Size
26
Recruitment Window Months
37
Consent Approach
Informed consent is obtained from parent(s)/legal representative(s) using pediatric subject information and consent/ICD documents (Part A and Part B specific ICF/ICD documents and a pediatric privacy supplement). Country/language-specific ICF/ICD and recruitment materials are available (documents in English, Italian, Hungarian, Greek, Bulgarian, Slovak, Spanish are present in the dossier). Assent is not applicable for neonates/infants enrolled.

Methods

  • HCP study posters (country-specific versions) — materials for healthcare professionals to inform about the study (documents present for Italy, Hungary, Greece, Bulgaria, Slovakia, Spain).
  • Study brochures — participant/parent-facing information brochures available in country-specific versions.
  • Informed consent flipbook — consent/assent informational flipbook materials (country-specific versions) to support consent discussions.
  • Pediatric education material — materials aimed at parents/guardians and healthcare staff to explain pediatric aspects of participation.
  • Recruitment and informed consent procedure documents — formal recruitment and consent procedures provided (country-specific documents).

Geography

Total Number Of Sites
27
Total Number Of Participants
26

Italy

Earliest CTIS Part Ii Submission Date
21-01-2025
Latest Decision Or Authorization Date
30-04-2025
Processing Time Days
99
Number Of Sites
5
Number Of Participants
5

Sites

Site Name
Azienda Ospedale-Universita Padova
Department Name
Dipartimento di Salute della donna e del bambino
Contact Person Name
Eugenio Baraldi
Contact Person Email
eugenio.baraldi@unipd.it
Site Name
Azienda Socio Sanitaria Territoriale Degli Spedali Civili Di Brescia
Department Name
Pediatria
Contact Person Name
Raffaele Badolato
Contact Person Email
raffaele.badolato@unibs.it
Site Name
Azienda Sanitaria Locale Della Provincia Di Biella
Department Name
SCDU Pediatria e Neonatologia
Contact Person Name
Paolo Manzoni
Site Name
Azienda Ospedaliera Universitaria Meyer IRCCS
Department Name
SOD Malattie Infettive Pediatriche
Contact Person Name
Carlotta Montagnani
Contact Person Email
carlotta.montagnani@meyer.it
Site Name
ASST Fatebenefratelli Sacco
Department Name
Pediatria
Contact Person Name
Vania Giacomet
Contact Person Email
vania.giacomet@unimi.it

Hungary

Earliest CTIS Part Ii Submission Date
14-03-2025
Latest Decision Or Authorization Date
06-05-2025
Processing Time Days
53
Number Of Sites
5
Number Of Participants
4

Sites

Site Name
Semmelweis University
Department Name
Gyermekgyógyászati Klinika
Contact Person Name
Attila Szabó
Site Name
Semmelweis University
Department Name
Gyermekgyógyászati Klinika
Contact Person Name
Krisztina Kalocsai
Contact Person Email
kalocsai.k@gmail.com
Site Name
Eszak-Budai Szent Janos Centrumkorhaz
Department Name
Gyermek-, Koraszülött és Csecsemőosztály
Contact Person Name
Vera Tory
Contact Person Email
toryveron@gmail.com
Site Name
University Of Debrecen
Department Name
Gyermekgyógyászati Klinika, Neonatológia
Contact Person Name
Gergely Balázs
Contact Person Email
balazs.gergely@med.unideb.hu
Site Name
Kanizsai Dorottya Korhaz
Department Name
Csecsemő és Gyermekgyógyászati Osztály
Contact Person Name
Réka Olosz
Contact Person Email
oloszr@hotmail.com

Greece

Earliest CTIS Part Ii Submission Date
21-01-2025
Latest Decision Or Authorization Date
30-04-2025
Processing Time Days
99
Number Of Sites
4
Number Of Participants
4

Sites

Site Name
University General Hospital Of Heraklion
Department Name
Pediatric Intensive Care
Contact Person Name
Ilia Stavroula
Contact Person Email
stavroula.ilia@uoc.gr
Site Name
Ippokratio General Hospital Of Thessaloniki
Department Name
3rd Pediatric Department
Contact Person Name
Elias Iosifidis
Contact Person Email
iosifidish@gmail.com
Site Name
General University Hospital Of Larissa
Department Name
Department of Pediatrics
Contact Person Name
Ioanna Grivea
Contact Person Email
ioanna.grivea@gmail.com
Site Name
University General Hospital Attikon
Department Name
3rd Department of Pediatrics
Contact Person Name
Vassiliki Papaevangelou
Contact Person Email
vpapaev@med.uoa.gr

Bulgaria

Earliest CTIS Part Ii Submission Date
21-01-2025
Latest Decision Or Authorization Date
02-05-2025
Processing Time Days
101
Number Of Sites
4
Number Of Participants
4

Sites

Site Name
Universitetska Mnogoprofilna bolnica za aktivno lechenie Deva Maria EOOD
Department Name
Department of Neonatology
Contact Person Name
Krasimira Dobreva
Contact Person Email
k.dobreva@mail.bg
Site Name
University Multiprofile Hospital For Active Treatment Saint Georgi EAD
Department Name
Clinic of Pediatric Surgery
Contact Person Name
Penka Stefanova-Peeva
Contact Person Email
pepi_stef@hotmail.com
Site Name
University Multiprofessional Hospital For Active Treatment Kanev AD
Department Name
Department of Neonatology
Contact Person Name
Liliya Georgieva
Contact Person Email
lilidg@mail.bg
Site Name
Acibadem City Clinic Tokuda University Hospital EAD
Department Name
Department of Neonatology
Contact Person Name
Radka Maslarska
Contact Person Email
r_maslarska17@abv.bg

Slovakia

Earliest CTIS Part Ii Submission Date
01-04-2025
Latest Decision Or Authorization Date
30-04-2025
Processing Time Days
29
Number Of Sites
5
Number Of Participants
5

Sites

Site Name
Univerzitna Nemocnica Martin
Department Name
Klinika detskej anestéziológie a intenzívnej medicíny
Contact Person Name
Slavomír Nosáľ
Contact Person Email
slavonosal@yahoo.com
Site Name
Univerzitna Nemocnica Martin
Department Name
Neonatologická klinika
Contact Person Name
Lucia Časnocha Lúčanová
Contact Person Email
luciacasnocha@gmail.com
Site Name
Univerzitna Nemocnica Martin
Department Name
Klinika detí a dorastu, Oddelenie pediatrickej intenzívnej medicíny
Contact Person Name
Ján Mikler
Contact Person Email
miklerjan@gmail.com
Site Name
Národny ustav srdcovych a cievnych chorob a.s.
Department Name
Oddelenie anesteziológie a intenzívnej medicíny
Contact Person Name
Ľubica Kováčiková
Site Name
Detska Fakultna Nemocnica S Poliklinikou Banska Bystrica
Department Name
II. Klinika pediatrickej anestéziológie a intenzívnej medicíny SZU
Contact Person Name
Oliver Petrík
Contact Person Email
oliver.petrik@dfnbb.sk

Spain

Earliest CTIS Part Ii Submission Date
16-07-2025
Latest Decision Or Authorization Date
03-10-2025
Processing Time Days
79
Number Of Sites
4
Number Of Participants
4

Sites

Site Name
Hospital Universitario Hm Monteprincipe
Department Name
Pediatría
Contact Person Name
Silvina Laura Natalini Martínez
Contact Person Email
slnatalini@hmhospitales.com
Site Name
Hospital Universitario La Paz
Department Name
Pediatría, Enfermedades Infecciosas y Tropicales
Contact Person Name
Fernando Baquero Artigao
Contact Person Email
fbaqueroartigao@gmail.com
Site Name
Hospital Sant Joan De Deu Barcelona
Department Name
Infecciosas
Contact Person Name
Claudia Fortuny Guasch
Contact Person Email
claudia.fortuny@sjd.es
Site Name
Hospital Universitario 12 De Octubre
Department Name
Pediatría
Contact Person Name
Daniel Blázquez Gamero
Contact Person Email
danielblazquezgamero@gmail.com

Sponsor

Primary sponsor

Full Name
Pfizer Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
Labcorp Central Laboratory Services LP
Responsibilities
Central laboratory services
Name
Labcorp Central Laboratory Services SARL
Responsibilities
Central laboratory services

Third parties

  • {"country":"United States","full_name":"Labcorp Central Laboratory Services LP","duties_or_roles":"Central laboratory services (sponsor third party; sponsorDuties code 4)","organisation_type":"Pharmaceutical company / Laboratory services"}
  • {"country":"Switzerland","full_name":"Labcorp Central Laboratory Services SARL","duties_or_roles":"Central laboratory services (sponsor third party; sponsorDuties code 4)","organisation_type":"Pharmaceutical company / Laboratory services"}

Investigational products

Investigational Product Name
Aztreonam and Avibactam (1.5g/0.5g) Powder for Concentrate for Solution for Infusion
Active Substance
Aztreonam, Avibactam sodium
Modality
Small molecule
Routes Of Administration
Intravenous infusion
Route
Intravenous infusion
Authorisation Status
1
Starting Dose
IV ATM-AVI loading dose according to weight and age
Dose Levels
Loading dose and maintenance doses q6h or q8h according to age; minimum 3 days, maximum 14 days
Frequency
q6h or q8h according to age
Maximum Dose
173.3 mg/kg per day
Investigational Product Name
Metronidazole (various formulations e.g. 500 mg / 100 ml Intravenous Infusion)
Active Substance
Metronidazole
Modality
Small molecule
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
1/2
Starting Dose
Metronidazole administered IV as per investigator discretion or per combination regimen for cIAI
Dose Levels
As per local product and investigator decision; used in combination for cIAI where indicated
Maximum Dose
40 mg/kg per day
Combination Treatment
Yes

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