RecruitingPhase 4NCT06709196

Clinical Trial Testing Whether Targeted Antibiotic Prophylaxis Can Reduce Infections After Cystectomy Compared to Empiric Prophylaxis

REINFORCE - Reducing Infection-related Readmissions Following Cystectomy. a Multicentre Randomised Clinical Trial Testing Superiority of Individualised Targeted Antibiotic Prophylaxis Over Empiric Prophylaxis At Ureteral Stent Removal to Reduce Infection-related Readmissions Following Cystectomy.


Sponsor

Rigshospitalet, Denmark

Enrollment

248 participants

Start Date

Jan 7, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The aim of this trial is to test whether postoperative antibiotics targeted towards bacteria in the urine can reduce the risk of infection after surgical removal of the bladder (cystectomy) compared to a standardised antibiotic prophylaxis. Participants undergoing cystectomy will be randomly assigned to postoperatively receive (A) a standardised orally administered antibiotic prophylaxis currently given at Rigshospitalet, Copenhagen or (B) a conventional orally administered antibiotic prophylaxis targeting bacteria found in the urine postoperatively. The investigators' hypothesis is that the targeted prophylactic antibiotic strategy will reduce the number of infection-related readmissions within 90 days of surgery compared to the standardised prophylaxis.


Eligibility

Min Age: 18 Years

Inclusion Criteria4

  • Age at surgery ≥ 18 years
  • Ability to understand and sign an informed consent
  • Malignant or benign indication for undergoing cystectomy
  • Planned ileal conduit as urinary diversion

Exclusion Criteria2

  • Previous severe allergic reaction to antimicrobial treatment
  • Long-term prophylactic antibiotic treatment which is expected to be continued after the cystectomy

Interventions

DRUGPivmecillinam

Orally administered pivmecillinam 400mg

DRUGPivmecillinam

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGAmoxicillin clavulanic acid

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGAmoxicillin

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGCefuroxime

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGCiprofloxacin

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGLinezolid

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGNitrofurantoin

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGTrimethoprim

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGSulfamethoxazole trimethoprim

Orally administered targeted antimicrobial prophylaxis based on a urine culture.

DRUGFluconazole

Orally administered targeted antimicrobial prophylaxis based on a urine culture.


Locations(5)

Department of Urology, Aalborg University Hospital

Aalborg, Denmark

Department of Urology, Aarhus University Hospital

Aarhus, Denmark

Department of Urology, Rigshospitalet

Copenhagen, Denmark

Department of Urology, Herlev and Gentofte Hospital

Herlev, Denmark

Department of Urology, Odense University Hospital

Odense, Denmark

View Full Details on ClinicalTrials.gov

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NCT06709196


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