RecruitingPhase 4NCT05652374

Gag Therapy for Recurrent Urinary Tract Infection Assessing Comparability to International Nitrofurantoin Gold Standard Study


Sponsor

Radboud University Medical Center

Enrollment

100 participants

Start Date

Oct 20, 2022

Study Type

INTERVENTIONAL

Summary

The GT RACING is a study comparing the efficacy of HA-CS bladder installations with prophylactic antibiotics in the prevention of recurrent urinary tract infections (rUTI).


Eligibility

Sex: FEMALEMin Age: 18 Years

Inclusion Criteria2

  • Adult female patients (>18 years) who had at least 3 symptomatic UTI's in the previous year with no adequate curable therapeutic options (e.g. bladder stones)
  • At least one UTI's must be confirmed with a positive culture and antibiogram, further UTI's must be confirmed with a urine sediment with positive nitrite or a positive culture.

Exclusion Criteria26

  • Male
  • < 18 years
  • Pregnant
  • Already on GAG therapy
  • Already on prophylactic antibiotics
  • Started or stopped cranberry/d-mannose therapy or vaginal estrogenic creme in the last two months
  • Had Gentamicin or other antibiotic instillations in the previous 2 months
  • Allergic to >3 regular used antibiotics in Dutch guidelines (ed. Nitrofurantoin, trimethoprim, Fosfomycin)
  • A urinary fistula
  • Urinary stones
  • Urogenital cancer
  • Bladder Pain Syndrome - Interstitial Cystitis
  • Chronic pelvic pain
  • Had a STD untreated or treated in the previous 2 months
  • A urinary diversion
  • An Indwelling catheter
  • A suprapubic catheter
  • Performing >1/day self-catheterization
  • A residue after voiding (PVR) of >200ml
  • Unable (also legal) to give informed consent
  • Recurrent urosepsis
  • Multiresistant bacteria in previous urine cultures
  • Contra-indications and interactions for Nitrofurantoin: severe kidney disfunction (GFR < 30), lung- or liver problems or neuropathy after previous use of nitrofurantoin, acute porphyria, known G6PD deficiency, use of magnesium trisilicate.
  • Contra-indications and interactions for trimethoprim: severe kidney or liver dysfunction, blood count abnormality, use of vitamin K antagonists, use of folic acid antagonists, use of ace inhibitors
  • Severe lung/respiratory disfunction (reduced lung capacity, lung cancer, fibrosis, COPD)
  • Does not tolerate catheterization

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Interventions

DEVICEIaluril 50ml Prefill

50ml of sterile Ialuril (HA 1.6% CS 2%) bladder instillations weekly for 6 weeks, followed by monthly maintenance therapy for 6 months

DRUGNitrofurantoin

nitrofurantoin 100mg daily (1dd100mg or 2dd50mg) for 6 months. ( In case of resistance/intolerance/allergy for nitrofurantoin alternatively trimethoprim 100mg daily)


Locations(3)

Radboudumc

Nijmegen, Gelderland, Netherlands

Rijnstate ziekenhuis

Arnhem, Netherlands

Canisius wilhelmina ziekenhuis

Nijmegen, Netherlands

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NCT05652374