Antibiotics for Protecting Gut Bacteria During Stem Cell Transplant

Not currently recruiting at 1 trial location
BG
SS
JP
Overseen ByJonathan Peled, MD, PhD
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Memorial Sloan Kettering Cancer Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different antibiotics, cefepime and piperacillin-tazobactam, affect the beneficial bacteria in the gut during stem cell transplants. These bacteria aid digestion and overall health, and their loss can lead to infections and other complications. The study aims to determine which antibiotic better protects these helpful organisms. Individuals with any blood cancer, such as leukemia or lymphoma, undergoing a stem cell transplant might be suitable participants, especially if they do not have severe allergies to the study antibiotics. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of people.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are on prolonged antibiotic treatment for an ongoing infection, you may not be eligible to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that both Cefepime and Piperacillin-tazobactam are generally safe for stem cell transplant patients, but certain considerations are important.

Cefepime effectively prevents infections in these patients, who often have weakened immune systems. While Cefepime manages this risk, monitoring for side effects, such as allergic reactions or changes in blood cell counts, is crucial.

Research also supports Piperacillin-tazobactam as an effective antibiotic for preventing infections after stem cell transplants. It is usually well-tolerated, but mild side effects like nausea or diarrhea may occur. Caution is necessary for allergic reactions, especially in those with a history of penicillin allergies.

Both antibiotics prevent infections during the vulnerable period after a stem cell transplant. Although considered safe and generally well-tolerated, patients require close monitoring for any adverse reactions.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments because they explore new ways to protect gut bacteria during stem cell transplants. Unlike standard antibiotics, which can indiscriminately wipe out gut bacteria, cefepime is being studied for its potential to be less disruptive to the gut microbiome. Additionally, piperacillin-tazobactam is being compared as an active comparator to see if it offers better protection for gut health during these transplants. These treatments could lead to better outcomes by maintaining a healthier balance of gut bacteria, which is crucial for recovery and overall health after transplantation.

What evidence suggests that this trial's antibiotics could be effective for protecting gut bacteria during stem cell transplant?

This trial will compare the effects of two antibiotics, cefepime and piperacillin-tazobactam, on gut bacteria during stem cell transplants. Studies have shown that antibiotics can affect helpful gut bacteria, especially during such procedures. Research indicates that cefepime can reduce the variety of gut bacteria, potentially increasing the risk of infections or graft-versus-host disease (GVHD). Piperacillin-tazobactam, another antibiotic in this trial, is known to cause significant changes in gut bacteria. Both antibiotics can impact the gut microbiome, affecting outcomes like GVHD after transplants. These changes in gut bacteria are crucial because they can influence recovery and overall health during and after the stem cell transplant process.678910

Who Is on the Research Team?

SS

Susan Seo, MD

Principal Investigator

Memorial Sloan Kettering Cancer Center

Are You a Good Fit for This Trial?

Adults with blood cancers undergoing stem cell transplants can join this trial. They must not have been on gut-affecting antibiotics for long periods recently, should not currently have a fever, and their kidneys need to work well. Those allergic to the study drugs or with certain drug-resistant infections cannot participate.

Inclusion Criteria

I am undergoing treatment for a blood cancer.

Exclusion Criteria

I currently have a fever.
My kidney function is low, with an eGFR under 30.
I have been on strong antibiotics for more than 10 days recently to prevent or treat an infection.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either piperacillin-tazobactam or cefepime to assess the impact on gut bacteria

7 days
Baseline visit, 1 visit (in-person) at 7 days

Follow-up

Participants are monitored for changes in gut microbiota and safety post-treatment

14 weeks
Visits on post-transplant days +28, +56, and +100

What Are the Treatments Tested in This Trial?

Interventions

  • Cefepime
  • Piperacillin-tazobactam
Trial Overview The trial is testing how two antibiotics, Piperacillin-tazobactam and cefepime, impact the good bacteria in the gut during stem cell transplant recovery. It will involve monitoring changes in these bacteria through urine samples at several points before and after starting antibiotic therapy.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: cefepimeExperimental Treatment1 Intervention
Group II: Piperacillin-tazobactamActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials
1,998
Recruited
602,000+

Citations

Gut microbiota injury in allogeneic haematopoietic stem cell ...Choosing the best antibiotic to protect friendly gut bacteria during the course of stem cell transplant, To compare the effect between piperacillin ...
Increased GVHD-related mortality with broad-spectrum ...After allogeneic hematopoietic stem cell transplantation (allo-HSCT), intestinal bacteria modulate risks of infection and graft-versus-host disease (GVHD).
Antibiotic Exposure, Not Alloreactivity, Is the Major Driver of ...Antibiotic exposure is a stronger driver of loss of intestinal microbiome diversity in hematopoietic cell transplantation than donor source.
NCT03078010 | Choosing the Best Antibiotic to Protect ...The purpose of this study is to see how different antibiotics affect the community of friendly bacteria existing in the intestinal tract (gut).
Advancing therapeutic strategies for graft-versus-host ...This review examines research advancements and the practical use of intestinal bacteria in GVHD following allo-HSCT.
Current Trends of Infectious Complications following ...This study was to analyze the infectious complications after hematopoietic stem cell transplantation (HSCT) according to the recent changes of HSCT.
Antibacterial Resistance in Patients with Hematopoietic Stem ...Recipients of hematopoietic stem cell transplantation (HSCT) are at substantial risk of bacterial, fungal, viral, and parasitic infections.
Review Quality Improvement in Hematopoietic Stem Cell ...Patients undergoing HSCT undergo prolonged hospitalization and are at risk for multiple acute and long-term complications, including transplant-related ...
Efficacy of antibiotic prophylaxis in patients with cancer and ...A systematic review was conducted to determine the efficacy and safety of antibiotic prophylaxis in patients with cancer and hematopoietic ...
Challenges and Opportunities in Antimicrobial Stewardship ...HSCT patients are particularly susceptible to significant drug–drug interactions, due to the frequent need for antimicrobial prophylaxis and treatment, ...
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