Antibiotic Duration for Infections in Children

(TRIAD Trial)

Not yet recruiting at 9 trial locations
KA
AW
Overseen ByAllison Wiedeman
Age: < 18
Sex: Any
Trial Phase: Phase 4
Sponsor: University of California, San Francisco
Must be taking: Antibiotics
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?

Infections like pneumonia, skin and soft tissue infection (also called SSTI or cellulitis), and urinary tract infections (UTI) are some of the most common reasons children get admitted to the hospital. All three of these conditions require antibiotics for treatment. Although antibiotics are needed to treat the infection and help children feel better, taking them longer than needed can negatively impact children and their families. Negative impacts include things like the burdens of taking more medications and medication side effects. There are guidelines (instructions) from expert medical organizations that suggest the number of days children need antibiotics, but they give a wide range (between 5 and 14 days). Unfortunately, these guidelines are not based on high-quality studies. National data suggests that doctors often choose on the higher end of this range when writing prescriptions for children in the hospital.

Our three caregiver co-investigators, other parents of hospitalized children, doctors, other care providers, and researchers, all believe that additional study is needed to determine the best length of antibiotic treatment that weighs both the benefits and harms of antibiotics.

The goal of our study is to understand if 5 total days of antibiotic treatment compared to 10 total days of antibiotic treatment is better for children who have been in the hospital for pneumonia, SSTI, or UTI. We will study this question through a randomized control trial. In other words, half of the children will receive 5-days of antibiotics and the other half will receive 10-days of antibiotics. Children in this study (and their caregivers) will not know how many days of antibiotics they will receive to cure their infection because some children will take a placebo (or a pill without antibiotics in it). Only the pharmacy will know if a child is getting antibiotic or placebo (for days 6-10 of treatment).

During the first phase of the trial (feasibility phase), 4 hospitals will enroll children in the study. We plan on enrolling 50 patients during this phase. We are starting with just 4 hospitals, so our study team can create and update our study plans if needed. We will closely review information about how many patients and families agree to participate, and if they have any trouble completing any part of the study. We will also interview families to understand the choice to participate in the study, the choice not to participate in the study, and what it is like to be in the study.

During the second study phase, we will enroll 1150 more patients across all 11 hospitals. Families will complete short, daily surveys until the 15th day after they started antibiotics, then a larger survey at day 15, at day 20, and at day 30. These surveys will ask about the child's symptoms and recovery from their illness, how the antibiotics are making them feel, and if they had to go back to their doctor, emergency room, or hospital. The answers to these questions will be combined to measure how well the child did, balancing feeling better and having bad effects from the antibiotics.

We will use mathematical tests to determine which antibiotic duration is better for treating these illnesses. We will complete other mathematical tests to see if all children should receive the same length of antibiotics or if certain children should be prescribed shorter courses and others longer courses.

Who Is on the Research Team?

SV

Sunitha V Kaiser, MD, MSc

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

This trial is for children hospitalized with pneumonia, skin and soft tissue infections (cellulitis), or urinary tract infections. They must be eligible to receive either a 5-day or 10-day antibiotic treatment. Specific inclusion and exclusion criteria details are not provided, but typically these would outline the age range, severity of condition, and any other health considerations.

Inclusion Criteria

My child has cellulitis, with or without a small abscess.
My child meets the specific criteria for a UTI diagnosis.
I am between 60 days and 17 years old, hospitalized with pneumonia, a skin infection, or a urinary tract infection, and receiving guideline-approved antibiotics.
See 2 more

Exclusion Criteria

Patients who live independently (without a parent or guardian in the home), including those in county or state custody
Patients who previously enrolled in the study
Patients not discharging home from hospital medicine service
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Feasibility Phase

Initial phase to enroll 50 patients across 4 hospitals to refine study plans and assess participation challenges

Varies

Treatment

Participants receive either 5 or 10 days of antibiotic treatment, with a placebo for days 6-10 in the 5-day group

10 days

Follow-up

Families complete daily surveys until day 15, with additional surveys on days 15, 20, and 30 to monitor symptoms and recovery

30 days

What Are the Treatments Tested in This Trial?

Interventions

  • Study Drug Placebo

Trial Overview

The study is testing whether a shorter course of antibiotics (5 days) is as effective as a longer course (10 days) in treating certain infections in hospitalized children. It's a randomized control trial where half the participants will receive the standard duration of antibiotics while the other half will get a placebo after day five.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Active Control

Group I: 5-day duration treatment strategyExperimental Treatment1 Intervention
Group II: 10-day duration treatment strategyActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials
2,636
Recruited
19,080,000+

Patient-Centered Outcomes Research Institute

Collaborator

Trials
592
Recruited
27,110,000+