Telavancin Pharmacokinetics in Cystic Fibrosis Patients
Cystic Fibrosis
About this trial
This is an interventional other trial for Cystic Fibrosis focused on measuring telavancin, lipoglycopeptide, MRSA, pharmacokinetics
Eligibility Criteria
Inclusion Criteria:
- Age 18 years or older
- Documented diagnosis of CF
- Acute pulmonary exacerbation as the primary reason for admission to the hospital with requirement to receive systemic antibiotic treatment, as defined by treating provider
- If female, subjects must be non-pregnant and non-lactating. Females can be either not of a child-bearing potential or if of a child-bearing potential, on acceptable modes of birth control such as abstinence from sexual intercourse, oral/parenteral contraceptives, or barrier method
Exclusion Criteria:
- History of any moderate or severe hypersensitivity or allergic reaction to telavancin or any component of telavancin, or any glycopeptide (e.g., vancomycin) antibiotic (a history of red man syndrome with vancomycin is not an exclusion criteria)
- History of any solid organ transplantation within the last 12 months
- Moderate to severe renal dysfunction defined as a creatinine clearance (CLCR) < 50 mL/min (as calculated by the Cockcroft-Gault equation using actual body weight) or requirement for continuous renal replacement therapy or hemodialysis
- Oliguria (urine output < 0.4 mL/kg/hr for at least 12 hours, up to a total of <20 mL/hr) or significant alterations in fluid/electrolyte homeostasis in a 72 hour window before enrollment with a history of renal compromise
- A hemoglobin less than 8 gm/dl at baseline
- Anticipated length of hospital stay less than 4 days, which would prevent completion of dose administration and pharmacokinetic sampling
- Receiving intravenous vancomycin at the time of enrollment or anticipation of requiring intravenous vancomycin during study participation (Note. Other antibiotics targeting Gram-positive bacteria such as MRSA are permitted)
- Receiving an anticoagulant AND requires specific coagulation testing (prothrombin time/international normalized ratio, activated partial thromboplastin time, activated clotting time, or coagulation based factor x activity assay) within 24 hours of receiving a telavancin dose (Note. Although telavancin does not interfere with coagulation, it may interfere with some assays used to monitor coagulation)
- Requirement of concomitant administration of agents containing a cyclodextrin solubilizer such as intravenous voriconazole or itraconazole
- Any rapidly-progressing disease or immediately life-threatening illness (defined as imminent death within 48 hours in the opinion of the investigator)
- Any condition or circumstance that, in the opinion of the investigator, would compromise the safety of the patient or the quality of study data
- Planned or prior participation in any other interventional drug study within 30 days
Sites / Locations
- Hartford Hospital
- IU Health University Hospital
- Riley Hospital for Children
- St. Christophers Hospital for Children
- University of Pittsburgh Medical Center Shadyside
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Telavancin injection Dose 1 (7.5mg/kg)
Telavancin injection Dose 2 (10mg/kg)
Telavancin injection Dose 3 (TBD)
The pharmacokinetics and tolerability of telavancin 7.5mg/kg q24h will be measured in 6 participants.
After completion and analysis of 7.5mg/kg group, the next 6 participants will receive 10mg/kg q24h, and pharmacokinetics and tolerability will be measured.
The third arm will enroll 6 participants to receive the following dose of telavancin q24h: 7.5, 10, 12.5, or 15 mg/kg. The final dose will be selected based on pharmacokinetic studies from first 12 participants, tolerability, and pharmacodynamic modeling.