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Urinary Tract InfectionPhase 4NCT04882085

Efficacy and Safety of CAZ-AVI in the Treatment of Infections Due to Carbapenem-resistant G- Pathogens in Chinese Adults

A Phase 4 study testing Zavicefta, Ceftazidime-Avibactam and Best Available Treatment in people with Urinary Tract Infection and Acute Pyelonephritis, run by Pfizer at 37 sites in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is an open-label, randomized, multi-center, interventional, active-controlled Phase 4 study to evaluate the efficacy and safety of CAZ-AVI versus BAT in the treatment of infected participants with selected infection types (Hospital Acquired Pneumonia [HAP] (including Ventilator-Associated Pneumonia [VAP])… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Zavicefta, Ceftazidime-Avibactam and Best Available Treatment
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
37 sitesChina
Study dates
26 Aug 2021to 31 Aug 2023
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female >18 years of age
  • Participant must have a diagnosis of an infection (HAP/VAP, cUTI, cIAI, BSI) due to confirmed carbapenem-resistant aerobic Gram-negative pathogens, requiring administration of IV antibacterial therapy
  • Participant who had received appropriate prior empiric antibacterial therapy for a carbapenem-resistant pathogen must meet at least 1 of the following criteria: no or no more than 24h; worsening of objective symptoms or signs after at least 48 hours of antibacterial therapy; no change of objective symptoms or signs after at least 72 hours of antibacterial therapy.
  • Capable of giving signed informed consent

Who cannot join

  • Other medical or psychiatric condition may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study.
  • Participant is expected to require more than 21 days of treatment
  • Participants who need more than 3 systemic antibiotics as part of best available treatment (BAT)
  • Previous administration with an investigational drug within 30 days or 5 half lives preceding the first dose of study intervention used in this study (whichever is longer).
  • Participant is pregnant or breastfeeding.
  • Acute Physiology and Chronic Health Evaluation (APACHE) II score >30 or <10 using the most recent available data.

Trial locations and contacts

37 sites in 1 country.

37 sites in 1 country

China37 sites
  • Affiliated Hospital of Hebei University

    Baoding, Hebei, 071000

  • Baotou Central Hospital

    Baotou, Inner Mongolia, 014000

  • Peking University Third Hospital

    Beijing, Beijing Municipality, 100191

  • The First Affiliated Hospital of Bengbu Medical

    Bengbu, Anhui, 233000

  • The First Affiliated Hospital of Bengbu Medical College

    Bengbu, Anhui, 233004

  • Chengdu Xinhua Hospital

    Chengdu, Sichuan, 610055

  • Chizhou People's Hospital

    Chizhou, Anhui, 247000

  • Fuyang People's Hospital

    Fuyang, Anhui, 236000

  • Guangzhou First People's Hospital

    Guangzhou, Guangdong, 510180

  • Affiliated Hospital of Guilin Medical College

    Guilin, Guangxi, 541001

  • Zhejiang Hospital

    Hangzhou, Zhejiang, 310013

  • Zhejiang Provincial People's Hospital

    Hangzhou, Zhejiang, 310014

  • Jiangyin People's Hospital

    Jiangyin, Jiangsu, 214400

  • Jiangyin People's Hospital

    Jiangyin, 214400

  • The First People's Hospital of Kunming (South Hospital)

    Kunming, Yunnan, 650034

  • The First people's Hospital of Kunming

    Kunming, Yunnan, 650034

  • The First People's Hospital of Kunming Ganmei Hospital (North Hospital)

    Kunming, Yunnan, 650224

  • Lishui People's Hospital

    Lishui, Zhejiang, 323000

  • Luoyang Central Hospital

    Luoyang, Henan, 471009

  • Jiangxi Provincial People's Hospital

    Nanchang, Jiangxi, 330006

  • NanYang central hospital

    Nanyang, Henan, 473000

  • Qingyuan People's Hospital

    Qingyuan, Guangdong, 511518

  • Huashan Hospital, Fudan University

    Shanghai, Shanghai Municipality, 200040

  • Shanghai Fifth People's Hospital, Fudan University

    Shanghai, 200240

  • Shenzhen People's Hospital

    Shenzhen, Guangdong, 518020

  • The Second People's Hospital of Shenzhen

    Shenzhen, Guangdong, 518035

  • Taizhou Hospital of Zhejiang Province

    Taizhou, Zhejiang, 317000

  • Tianjin Chest Hospital

    Tianjin, Tianjin Municipality, 300222

  • The 2nd Affiliated Hospital of WMU

    Wenzhou, Zhejiang, 325035

  • Wenzhou Central Hospital

    Wenzhou, Zhejiang, 325099

  • Zhongshan Hospital Xiamen University

    Xiamen, Fujian, 361004

  • Affiliated Hospital of Xuzhou Medical University

    Xuzhou, Jiangsu, 221006

  • Subei People's Hospital of Jiangsu province

    Yangzhou, Jiangsu, 225001

  • Affiliated Hospital of Guangdong Medical University

    Zhanjiang, Guangdong, 524000

  • Henan provincial people's hospital

    Zhengzhou, Henan, 450000

  • Henan provincial people's hospital

    Zhengzhou, Henan, 450003

  • Affiliated Hospital of Zunyi Medical University

    Zunyi, Guizhou, 563000

Other trials in China

About this study

Official title: AN OPEN-LABEL, RANDOMIZED, MULTI-CENTER, ACTIVE-CONTROLLED STUDY TO ESTIMATE THE EFFICACY AND SAFETY OF CEFTAZIDIME-AVIBACTAM (CAZ-AVI) VERSUS BEST AVAILABLE TREATMENT (BAT) IN THE TREATMENT OF INFECTIONS DUE TO CARBAPENEM-RESISTANT GRAM-NEGATIVE PATHOGENS IN CHINESE ADULTS

This is an open-label, randomized, multi-center, interventional, active-controlled Phase 4 study to evaluate the efficacy and safety of CAZ-AVI versus BAT in the treatment of infected participants with selected infection types (Hospital Acquired Pneumonia [HAP] (including Ventilator-Associated Pneumonia [VAP]); Complicated Urinary-Tract Infection [cUTI]; Complicated Intra-Abdominal Infection [cIAI]; Bloodstream Infection [BSI]) due to carbapenem-resistant Gram-negative pathogens in China.This study will be an estimation study. The statistical inference will be based on point estimate and confidence interval.

Being tested
Zavicefta, Ceftazidime-Avibactam, Best Available Treatment
Medical subject headings
Urinary Tract Infections, Healthcare-Associated Pneumonia, Pneumonia, Ventilator-Associated, Bacteremia, Intraabdominal Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Zavicefta, Ceftazidime-AvibactamDrug

    CAZ-AVI 2.5 g (2 g ceftazidime + 0.5 g avibactam) administered IV as a 2 hour infusion every 8 hours. Dose adjustments are available for participants with CrCL ≤50 mL/min.

  • Best Available TreatmentDrug

    main treatment expected to be used as either monotherapy or in combination are colistin, tigecycline, fosfomycin, amikacin, and meropenem

Study groups in NCT04882085
Study groupRoleWhat they receive
CAZ-AVIExperimentalceftazidime 2g plus avibactam 0.5g
Receives: Drug: Zavicefta, Ceftazidime-Avibactam
Best Available TreatmentActive comparatorBased on investigative site practice and local epidemiology and guideline
Receives: Drug: Best Available Treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With Clinical Cure at Test of Cure (TOC) Visit - Microbiologically Modified Intent-to-Treat (mMITT) Analysis Set

    Clinical cure was defined as improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for the index infection (i.e, complicated intra-abdominal infection [cIAI], complicated urinary-tract infection [cUTI], hospital-acquired pneumonia/ventilator-associated pneumonia [HAP/VAP] or bloodstream infection [BSI]) after study treatment. Also, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. The clinical response was assessed by the independent adjudication committee. 95 percent (%) confidence interval (CI) was calculated using Jeffrey's method.

    Measured: At TOC visit (From Day 21 up to Day 24)

Secondary outcomes (14)
  1. Percentage of Participants With Clinical Cure at TOC Visit - Microbiologically Evaluable (ME) Analysis Set

    Clinical cure: improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for index infection (i.e. cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also, for cIAI participants, no unplanned drainage or surgical intervention was necessary since initial procedure. 95% CI based on Jeffrey's method. ME analysis set (sub-set of mMITT): participants who received 3 days of study intervention, or received study intervention for >=48 hours with >= 80% compliance, or for <48 hours before discontinuation due to adverse event, no concomitant antibiotics against baseline carbapenem-resistant gram negative pathogens between first dose and TOC (excluding participants with failed study therapy requiring additional antibiotics), had baseline organisms genetically confirmed by central microbiological testing, no indeterminate clinical outcome at end of treatment (EOT) or TOC visits, no important protocol deviations that affect assessment of efficacy.

    Measured: At TOC visit (From Day 21 up to Day 24)

  2. Percentage of Participants With Clinical Cure at End of Treatment (EOT) Visit -mMITT Analysis Set

    Clinical cure was defined as improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for the index infection (i.e., cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also, for cIAI participants, no unplanned drainage or surgical intervention was necessary since the initial procedure. The clinical response was assessed by the independent adjudication committee. 95% CI was calculated using Jeffrey's method.

    Measured: At EOT visit (up to 24 hours after the last infusion on Day 14)

  3. Percentage of Participants With Clinical Cure at EOT Visit - ME Analysis Set

    Clinical cure: improvement in baseline signs and symptoms such that no further antimicrobial treatment was required for index infection (i.e., cIAI, cUTI, HAP/VAP or BSI) after study treatment. Also, for cIAI participants, no unplanned drainage or surgical intervention was necessary since initial procedure. 95% CI based on Jeffrey's method. ME analysis set (sub-set of mMITT): participants who received 3 days of study intervention, or received study intervention for >=48 hours with >= 80% compliance, or for <48 hours before discontinuation due to adverse event, no concomitant antibiotics against baseline carbapenem-resistant gram negative pathogens between first dose and TOC (excluding participants with failed study therapy requiring additional antibiotics), had baseline organisms genetically confirmed by central microbiological testing, no indeterminate clinical outcome at EOT or TOC visits, no important protocol deviations that affect assessment of efficacy.

    Measured: At EOT visit (up to 24 hours after the last infusion on Day 14)

  4. Percentage of Participants With Favorable Per-Participant Microbiological Response at TOC Visit - mMITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 colony forming units per milliliter [CFU/mL] for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/ clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants). 95% CI was calculated using Jeffrey's method.

    Measured: At TOC visit (From Day 21 up to Day 24)

  5. Percentage of Participants With Favorable Per-Participant Microbiological Response at TOC Visit - ME Analysis Set

    Favorable microbiological response=eradication: absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from appropriately obtained specimen at site of infection or presumed eradication: repeat culture of specimens were not performed/clinically indicated in participant who had clinical cure (specific to cIAI,HAP/VAP participants). 95% CI was calculated using Jeffrey's method. ME analysis set: participants received 3 days of study intervention,or received study intervention for >= 48 hours with >=80% compliance or for <48 hours before discontinuation due to adverse event, no concomitant antibiotics against baseline carbapenem-resistant gram negative pathogens between first dose and TOC (excluding participants with failed study therapy requiring additional antibiotics), had baseline organisms confirmed by central microbiological testing, no indeterminate clinical outcome at EOT/TOC, no important protocol deviations that affect assessment of efficacy.

    Measured: At TOC visit (From Day 21 up to Day 24)

  6. Percentage of Participants With Favorable Per-Participant Microbiological Response at EOT Visit - mMITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants). 95% CI was calculated using Jeffrey's method.

    Measured: At EOT visit (Up to 24 hours after last infusion on Day 14)

  7. Percentage of Participants With Favorable Per-Participant Microbiological Response at EOT Visit - ME Analysis Set

    Favorable microbiological response=eradication: absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from appropriately obtained specimen at site of infection or presumed eradication: repeat culture of specimens were not performed/clinically indicated in participant who had clinical cure (specific to cIAI,HAP/VAP participants). 95% CI was calculated using Jeffrey's method. ME analysis set: participants received 3 days of study intervention,or received study intervention for >= 48 hours with >=80% compliance or for <48 hours before discontinuation due to adverse event, no concomitant antibiotics against baseline carbapenem-resistant gram negative pathogens between first dose and TOC (excluding participants with failed study therapy requiring additional antibiotics), had baseline organisms confirmed by central microbiological testing, no indeterminate clinical outcome at EOT/TOC, no important protocol deviations that affect assessment of efficacy.

    Measured: At EOT visit (Up to 24 hours after last infusion on Day 14)

  8. Percentage of Participants With Favorable Per-Pathogen Microbiological Response at TOC Visit - mMITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants). 95% CI was calculated using Jeffrey's method.

    Measured: At TOC visit (From Day 21 up to Day 24)

  9. Percentage of Participants With Favorable Per-Pathogen Microbiological Response at EOT Visit - mMITT Analysis Set

    Favorable microbiological response was defined as eradication or presumed eradication. Eradication was defined as absence (or urine quantification <10^3 CFU/mL for cUTI participants) of causative pathogen from an appropriately obtained specimen at the site of infection. Presumed eradication was defined as repeat culture of specimens were not performed/clinically indicated in a participant who had a clinical response of cure (specific to cIAI and HAP/VAP participants). 95% CI was calculated using Jeffrey's method.

    Measured: At EOT visit (Up to 24 hours after last infusion on Day 14)

  10. Percentage of Participants Who Died Due to Any Cause Until Day 28

    Percentage of participants who died due to any cause up to Day 28 was reported in this outcome measure. The 95% CI was calculated using the Jeffrey's method.

    Measured: From first dose of study intervention (Day 1) up to Day 28

  11. Number of Participants With Treatment-Emergent Adverse Events

    An adverse event (AE) was any untoward medical occurrence in a study participant temporally associated with the use of study intervention, whether or not considered related to the study intervention. Treatment-emergent adverse event (TEAE) was any AE that started after the study intervention start date and time.

    Measured: From start of study treatment on Day 1 up to 32 days after the last dose of study intervention (Up to 46 days)

  12. Number of Participants With Discontinuation Due to Adverse Events

    Number of participants who discontinued the study due to adverse events were reported in this outcome measure. Discontinuations from study due to TEAEs included all participants with an AE record indicating that the AE caused permanent discontinuation from the study. Permanent discontinuations from any study intervention due to TEAEs included participants with an AE record indicating that action taken with study treatment was drug withdrawn but AE did not cause the participant to be discontinued from study.

    Measured: From start of study treatment on Day 1 up to 32 days after the last dose of study intervention (Up to 46 days)

  13. Number of Participants With Potentially Clinically Significant Post-baseline Hematology Values

    Potentially clinically significant hematology parameters included Hemoglobin (gram/deciliter), Hematocrit (%), Erythrocytes (10^12/Liter [L]): value < 0.8*lower limit of normal (LLN) and change (Chg) > 20% decrease, value > 1.3*upper limit of normal (ULN) and Chg > 30% increase. Platelets (10^9/L): Value < 0.65*LLN and Chg > 50% decrease, Value > 1.5*ULN and Chg > 100% increase. Leukocytes (10^9/L): Value < 0.65*LLN and Chg > 60% decrease, Value > 1.6*ULN and Chg > 100% increase. Lymphocytes (10^9/L): Value < 0.25*LLN and Chg > 75% decrease, Value > 1.5*ULN and Chg > 100% increase. Neutrophils (10^9/L): Value < 0.65*LLN and Chg > 75% decrease, Value > 1.6*ULN and Chg > 100% increase. Basophils (10^9/L), Eosinophils (10^9/L), Monocytes (10^9/L): Value > 4.0*ULN and Chg > 300% increase. Number of participants with potentially clinically significant values for any hematology parameters were reported in this outcome measure.

    Measured: From first dose of study treatment (Day 1) until TOC (Up to Day 24)

  14. Number of Participants With Potentially Clinically Significant Post-baseline Clinical Chemistry Values

    Potentially clinically significant criteria included Bilirubin(mg/dL): >2.0*ULN and Chg >150% increase (inc).Aspartate Aminotransferase,Alanine Aminotransferase(Units/Liter[U/L]):>3.0*ULN and Chg >200% inc.Alkaline Phosphatase(U/L):<0.5*LLN and Chg >80% decrease (dec),> 2.0*ULN and Chg >100% inc.Protein,Albumin(g/dL):<0.5*LLN and Chg >50% dec,>1.5*ULN and Chg >50% inc.Blood Urea Nitrogen(mg/dL):<0.2*LLN and Chg >100% dec, >3.0*ULN and Chg >200% inc.Creatinine(mg/dL):>2.0*ULN and Chg >100% inc.Sodium(milliequivalent[mEq]/L):<0.85*LLN and Chg >10% dec, >1.1*ULN and Chg >10% inc.Potassium,Chloride(mEq/L):<0.8*LLN and Chg >20% dec, >1.2*ULN and Chg >20% inc.Calcium(mg/dL):<0.7*LLN and Chg >30% dec,> 1.3*ULN and Chg >30% inc.Bicarbonate(mEq/L):<0.7*LLN and Chg >40% dec, >1.3*ULN and Chg >40% inc.Glucose(mg/dL):<0.6*LLN and Chg >40% dec, >3.0*ULN and Chg >200% inc.Number of participants with potentially clinically significant values for any clinical chemistry parameters were reported.

    Measured: From first dose of study treatment (Day 1) until TOC (Up to Day 24)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 May 2021
  2. Study start26 Aug 2021
  3. Primary completion31 Aug 2023
  4. Study completion31 Aug 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04882085
Sponsor's protocol ID
C3591033
Status last verified
Aug 2024
First submitted
27 Apr 2021
Last updated
21 Oct 2024
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.

Publications

  • Yuan J, Wang H, Zhang X, Xie F, Wang P, Zhu H, Irani P, Lu J, Liu F, Mu Y, Huang H, Zhang Y. Ceftazidime-avibactam for the treatment of infections caused by carbapenem-resistant Gram-negative pathogens in Chinese patients: A phase IV, multi-center, open-label study. Int J Antimicrob Agents. 2026 Oct 3:108030. doi: 10.1016/j.ijantimicag.2026.108030. Online ahead of print.

    PubMed 42829121

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Zavicefta, Ceftazidime-Avibactam and Best Available Treatment in people with Urinary Tract Infection and Acute Pyelonephritis, run by Pfizer at 37 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 37 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With Clinical Cure at Test of Cure (TOC) Visit - Microbiologically Modified Intent-to-Treat (mMITT) Analysis Set (time frame: At TOC visit (From Day 21 up to Day 24)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04882085, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Oct 2024.

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