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Pilot Study of the Safety and Clinical Efficacy of Topical Dermacyn™ Wound Care to Treat Mild Diabetic Foot Infections

Primary Purpose

Foot Ulcer, Diabetic

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Topical Dermacyn
Topical Dermacyn and Levofloxacin
Topical Saline and Levofloxacin
Sponsored by
Oculus Innovative Sciences, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Foot Ulcer, Diabetic focused on measuring diabetic, ulcer, infection, topical, wound

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • A patient must meet all of the following inclusion criteria to be enrolled in the study:

    1. Males and females > 18 years of age with diabetes mellitus (type 1 or type 2, controlled).
    2. Presence of infected, non-ischemic diabetic foot ulcer that involves skin and deeper soft tissue as stratified by IDSA guidelines and the UTC / 1B.
    3. Foot infections that are anticipated to be cured in 10 days of oral antibiotic therapy.
    4. Foot ulcers located in the plantar, dorsal or malleolar areas.
    5. Ulcers 1- 9 cm2 in size.
    6. An accessible infection site for culture.
    7. ABI by Doppler ≥ 0.8 or TcPO2 ≥ 30 mmHg.
    8. Palpable pulse on the study foot (either dorsalis or posterior tibial artery).
    9. Willing and able to give informed consent.
    10. Willing to comply with the requirements for participation in the study.

Exclusion Criteria:

Patients are excluded if they meet any of the following criteria at the time of randomization:

  1. Previous antibiotic treatment received for more than 24 hours within 72 hours of study.
  2. Necrotizing fasciitis, deep abscesses in the soft tissue, sinus tracts, gas gangrene, or infected burns.
  3. Superinfected eczema or other chronic inflammatory skin conditions (i.e., atopic dermatitis).
  4. The patient´s ulcer is located on the stump of an amputated extremity.
  5. The patient's ulcer is due to a non-diabetic etiology.
  6. Infections complicated by the presence of prosthetic materials.
  7. Osteomyelitis
  8. Females of childbearing potential who are unable to take adequate contraceptive precautions or are breastfeeding.
  9. Known to have liver disease, with total bilirubin > 5 times the Upper Limit of Normal (ULN); known to have neutropenia (absolute neutrophil count <500 cells/mm3).
  10. Hypersensitivity to chlorine or quinolones.
  11. Need for any additional concomitant systemic antibacterial agent other than the study drug(s).
  12. Concomitant glucocorticoid doses (> 5mg prednisone a day or equivalent).
  13. Adjuvant therapy with hyperbaric oxygen or topical formulations containing growth factors, antimicrobials or enzymatic debriders.
  14. A history of diseases of immune function (HIV, chronic granulomatous disease).
  15. Any medical condition that, in the investigator´s opinion, will require dose modification of Levofloxacin to less than 750 mg a day.
  16. Has received an investigational agent ≤1 month prior to the baseline evaluation.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

1

2

3

Arm Description

Topical Dermacyn

Topical Dermacyn and levofloxacin

Topical saline and levofloxacin

Outcomes

Primary Outcome Measures

To compare the rates of clinical success (cure + improvement) of Topical Dermacyn™ vs. Oral Levofloxacin vs. Combined therapy, in patients with mild diabetic foot infections in non ischemic ulcers

Secondary Outcome Measures

To compare the treatment groups with respect to microbiological outcome. Incidence of adverse events and other safety outcomes

Full Information

First Posted
August 14, 2007
Last Updated
January 7, 2008
Sponsor
Oculus Innovative Sciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00516958
Brief Title
Pilot Study of the Safety and Clinical Efficacy of Topical Dermacyn™ Wound Care to Treat Mild Diabetic Foot Infections
Official Title
An Open Label, Three Arm, Pilot Study of the Safety and Clinical Efficacy of Topical Dermacyn™ Wound Care vs. Oral Levofloxacin vs. Combined Therapy for Mild Diabetic Foot Infections
Study Type
Interventional

2. Study Status

Record Verification Date
January 2008
Overall Recruitment Status
Completed
Study Start Date
May 2007 (undefined)
Primary Completion Date
December 2007 (Actual)
Study Completion Date
December 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Oculus Innovative Sciences, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To compare the rates of clinical success of Topical Dermacyn™ vs. Oral Levofloxacin vs. Combined therapy, in subjects with mild diabetic foot infections in non-ischemic ulcers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Foot Ulcer, Diabetic
Keywords
diabetic, ulcer, infection, topical, wound

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
65 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Topical Dermacyn
Arm Title
2
Arm Type
Active Comparator
Arm Description
Topical Dermacyn and levofloxacin
Arm Title
3
Arm Type
Active Comparator
Arm Description
Topical saline and levofloxacin
Intervention Type
Drug
Intervention Name(s)
Topical Dermacyn
Other Intervention Name(s)
Dermacyn™ Wound Care
Intervention Description
Topical Dermacyn once a day for 10 Days
Intervention Type
Drug
Intervention Name(s)
Topical Dermacyn and Levofloxacin
Other Intervention Name(s)
Dermacyn™ Wound Care, Levaquin®
Intervention Description
Topical Dermacyn once a day and levofloxacin 750 mg PO per day; both for 10 days
Intervention Type
Drug
Intervention Name(s)
Topical Saline and Levofloxacin
Other Intervention Name(s)
Saline Solution, Levoquin®
Intervention Description
Topical saline once a day and levofloxacin 750 mg PO daily, both for 10 days
Primary Outcome Measure Information:
Title
To compare the rates of clinical success (cure + improvement) of Topical Dermacyn™ vs. Oral Levofloxacin vs. Combined therapy, in patients with mild diabetic foot infections in non ischemic ulcers
Time Frame
Visit 3 (Day 10); Visit 4 (Day 24)
Secondary Outcome Measure Information:
Title
To compare the treatment groups with respect to microbiological outcome. Incidence of adverse events and other safety outcomes
Time Frame
Visit 2 (Day 3); Visit 3 (Day 10)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A patient must meet all of the following inclusion criteria to be enrolled in the study: Males and females > 18 years of age with diabetes mellitus (type 1 or type 2, controlled). Presence of infected, non-ischemic diabetic foot ulcer that involves skin and deeper soft tissue as stratified by IDSA guidelines and the UTC / 1B. Foot infections that are anticipated to be cured in 10 days of oral antibiotic therapy. Foot ulcers located in the plantar, dorsal or malleolar areas. Ulcers 1- 9 cm2 in size. An accessible infection site for culture. ABI by Doppler ≥ 0.8 or TcPO2 ≥ 30 mmHg. Palpable pulse on the study foot (either dorsalis or posterior tibial artery). Willing and able to give informed consent. Willing to comply with the requirements for participation in the study. Exclusion Criteria: Patients are excluded if they meet any of the following criteria at the time of randomization: Previous antibiotic treatment received for more than 24 hours within 72 hours of study. Necrotizing fasciitis, deep abscesses in the soft tissue, sinus tracts, gas gangrene, or infected burns. Superinfected eczema or other chronic inflammatory skin conditions (i.e., atopic dermatitis). The patient´s ulcer is located on the stump of an amputated extremity. The patient's ulcer is due to a non-diabetic etiology. Infections complicated by the presence of prosthetic materials. Osteomyelitis Females of childbearing potential who are unable to take adequate contraceptive precautions or are breastfeeding. Known to have liver disease, with total bilirubin > 5 times the Upper Limit of Normal (ULN); known to have neutropenia (absolute neutrophil count <500 cells/mm3). Hypersensitivity to chlorine or quinolones. Need for any additional concomitant systemic antibacterial agent other than the study drug(s). Concomitant glucocorticoid doses (> 5mg prednisone a day or equivalent). Adjuvant therapy with hyperbaric oxygen or topical formulations containing growth factors, antimicrobials or enzymatic debriders. A history of diseases of immune function (HIV, chronic granulomatous disease). Any medical condition that, in the investigator´s opinion, will require dose modification of Levofloxacin to less than 750 mg a day. Has received an investigational agent ≤1 month prior to the baseline evaluation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andres Gutierrez, M.D., Ph.D.
Organizational Affiliation
Oculus Innovative Sciences
Official's Role
Study Director
Facility Information:
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85710
Country
United States
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90063-2326
Country
United States
City
San Diego
State/Province
California
ZIP/Postal Code
92103-8896
Country
United States
City
Santa Rosa
State/Province
California
ZIP/Postal Code
34669
Country
United States
City
Denver
State/Province
Colorado
ZIP/Postal Code
80220
Country
United States
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06515
Country
United States
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33486
Country
United States
City
Spring Hill
State/Province
Florida
ZIP/Postal Code
34609
Country
United States
City
Evansville
State/Province
Indiana
ZIP/Postal Code
47714
Country
United States
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40222
Country
United States
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
City
Harrisburgh
State/Province
Pennsylvania
ZIP/Postal Code
17112
Country
United States
City
Hazleton
State/Province
Pennsylvania
ZIP/Postal Code
18201
Country
United States
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
54102
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17344198
Citation
Goretti C, Mazzurco S, Nobili LA, Macchiarini S, Tedeschi A, Palumbo F, Scatena A, Rizzo L, Piaggesi A. Clinical outcomes of wide postsurgical lesions in the infected diabetic foot managed with 2 different local treatment regimes compared using a quasi-experimental study design: a preliminary communication. Int J Low Extrem Wounds. 2007 Mar;6(1):22-7. doi: 10.1177/1534734606298543.
Results Reference
background
PubMed Identifier
16242210
Citation
Landa-Solis C, Gonzalez-Espinosa D, Guzman-Soriano B, Snyder M, Reyes-Teran G, Torres K, Gutierrez AA. Microcyn: a novel super-oxidized water with neutral pH and disinfectant activity. J Hosp Infect. 2005 Dec;61(4):291-9. doi: 10.1016/j.jhin.2005.04.021. Epub 2005 Oct 19.
Results Reference
background
PubMed Identifier
17553033
Citation
Duc Ql, Breetveld M, Middelkoop E, Scheper RJ, Ulrich MM, Gibbs S. A cytotoxic analysis of antiseptic medication on skin substitutes and autograft. Br J Dermatol. 2007 Jul;157(1):33-40. doi: 10.1111/j.1365-2133.2007.07990.x. Epub 2007 Jun 6.
Results Reference
background
PubMed Identifier
17570318
Citation
Medina-Tamayo J, Sanchez-Miranda E, Balleza-Tapia H, Ambriz X, Cid ME, Gonzalez-Espinosa D, Gutierrez AA, Gonzalez-Espinosa C. Super-oxidized solution inhibits IgE-antigen-induced degranulation and cytokine release in mast cells. Int Immunopharmacol. 2007 Aug;7(8):1013-24. doi: 10.1016/j.intimp.2007.03.005. Epub 2007 Apr 16.
Results Reference
background
PubMed Identifier
16771079
Citation
Zahumensky E. [Infections and diabetic foot syndrome in field practice]. Vnitr Lek. 2006 May;52(5):411-6. Czech.
Results Reference
background

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Pilot Study of the Safety and Clinical Efficacy of Topical Dermacyn™ Wound Care to Treat Mild Diabetic Foot Infections

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