A Phase III Multicenter, Open Label Randomized Controlled Trial of Cefoxitin versus Piperacillin-Tazobactam as Surgical Antibiotic Prophylaxis in Patients Undergoing Pancreatoduodenectomy
18 Years and older, Male and Female
17-418 (primary)
NCI-2017-01743
Summary
This randomized phase III trial studies cefoxitin compared with piperacillin-tazobactam in preventing surgical site infections in patients undergoing pancreatoduodenectomy. Antibiotics, such as cefoxitin and piperacillin-tazobactam, may prevent or control infections in patients undergoing surgery. Giving cefoxitin or piperacillin-tazobactam to find out which antibiotic is better may help patients avoid surgical site infections after their pancreatoduodenectomy, avoid delays in recovery, and minimize extra burdens placed on patients, their families and caregivers.
Objectives
PRIMARY OBJECTIVES:
I. To compare the effectiveness of cefoxitin, a second generation cephalosporin (Cohort 1), with piperacillin-tazobactam, a broad-spectrum penicillin (Cohort 2), as surgical antibiotic prophylaxis in decreasing the overall rate of postoperative surgical site infections (SSIs) in patients undergoing pancreatoduodenectomy (PD).
SECONDARY OBJECTIVES:
I. To measure and compare the occurrences of non-SSI morbidity and healthcare utilization occurring in patients given a second generation cephalosporin as surgical antibiotic prophylaxis (Cohort 1) versus a broad-spectrum penicillin (Cohort 2).
TERTIARY OBJECTIVES:
I. To determine the bacterial isolates and sensitivities of SSIs that occur in patients in both cohorts.
II. To determine the bacterial isolates and sensitivities of intraoperative bile cultures obtained from patients in both cohorts.
OUTLINE: Patients are randomized to 1 of 2 cohorts.
COHORT A: Patients receive cefoxitin intravenously (IV) once within 1 hour prior to PD incision, every 2-4 hours until closure of incision, and discontinued within 24 hours after anesthesia end time.
COHORT B: Patients receive piperacillin-tazobactam IV once within 1 hour prior to PD incision, every 2-4 hours until closure of incision, and discontinued within 24 hours after anesthesia end time.
After completion of study treatment, patients are followed for 30 days.
Treatment Sites in Georgia
1440 Clifton Road
Atlanta, GA 30322
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