A Study to Assess the Safety, Tolerability, and Pharmacokinetics of Cefiderocol in Hospitalized Pediatric Participants
Gram-negative Bacterial Infections, Hospital Acquired Bacterial Pneumonia (HABP), Complicated Urinary Tract Infection (cUTI)
About this trial
This is an interventional treatment trial for Gram-negative Bacterial Infections
Eligibility Criteria
Inclusion Criteria:
- Participant's parent(s) or legally authorized representative(s) (LAR) provides written informed consent in accordance with regional- and country-specific laws and regulations
- Participant provides written informed assent, when feasible (age of assent to be determined by institutional review board/independent ethics committee [IRBs/IECs] or be consistent with local legal requirements)
- Hospitalized participant is 3 months to < 18 years of age at the time written informed consent/assent is obtained for the multiple-dose phase. Hospitalized participant is 3 months to < 12 years of age at the time written informed consent/assent is obtained for the single-dose phase.
Single-dose phase: Participant has a suspected or confirmed infection type (including but not limited to cUTI, complicated intra-abdominal infections [cIAI], pneumonia, HABP/VABP, and sepsis or bloodstream infections [BSI]) that requires hospitalization for treatment with IV antibiotics.
Multiple-dose phase: Participant has a suspected or confirmed cUTI, HABP, or VABP that requires hospitalization for treatment with IV antibiotics
- If participant is a sexually active female of childbearing potential and has reached menarche or Tanner stage 3, participant agrees to use barrier contraception (including condom, diaphragm, or cervical cap) with spermicide or agrees to use a highly effective method of contraception (including contraceptive implant, injectable contraceptive, combination oral contraceptive, or an intrauterine [IUD] contraceptive device) from Screening up to 28 days after administration of the last dose of cefiderocol.
Exclusion Criteria:
- Participant has a documented history of any hypersensitivity or allergic reaction to any β-lactam antibiotic (Note: for β-lactams, a history of a mild rash followed by uneventful re-exposure is not a contraindication to enrollment.)
- Multiple-dose only: Participant has an infection caused only by a confirmed Gram-positive pathogen.
- Participant has a suspected or confirmed central nervous system (CNS) infection (for example, meningitis, brain abscess, shunt infection) or osteomyelitis (which would require prolonged antibiotic therapy).
- Participant has cystic fibrosis.
Single-dose phase: Participant has moderate or severe renal impairment based on estimated glomerular filtration rate (eGFR) (based on the Schwartz equation if ≥ 3 months to < 1 year of age and modified Bedside Schwartz equation if ≥ 1 to < 18 years of age) of < 60 milliliter (mL)/ minute (min)/1.73 square meters (m^2)² at Screening .
Multiple-dose phase: Participant has an eGFR (based on the Schwartz equation if ≥ 3 months to < 1 year of age and modified Bedside Schwartz equation if ≥ 1 to < 18 years of age) of < 15 mL/min/1.73 m² at Screening.
- Participant has end-stage renal disease (ESRD), is on hemodialysis (HD), or receiving continuous venovenous hemofiltration (CVVH).
- Participant has experienced shock in the prior month or is in shock at the time of Screening.
- Participant has severe neutropenia or is severely immunocompromised.
- Participant has multiorgan failure .
- Participant with a life expectancy of < 30 days due to severity of a concurrent illness.
- Participant is a female who has a positive pregnancy test at Screening.
- Participant is a female who is breastfeeding.
- Participant has received any other investigational medicinal product (IMP) within 30 days.
- Participant has any condition or circumstance that, in the opinion of the investigator, would compromise the safety of the participant or the quality of the study data, including acute trauma to the pelvis or urinary tract.
- Participant is receiving vasopressor therapy at Screening.
Sites / Locations
- Cook Children's Medical Center
- Queensland Children's Health Precinct Level 8, Centre for Children's Health Research 62 Graham StreetRecruiting
- Heraklion University General Hospital
- University General Hospital of LarissaRecruiting
- University Hospital "ATTIKON" 3rd Pediatric Clinic of NKUARecruiting
- Hippokration Hospital 3rd Pediatric Clinic of AUTH Konstantinoupoleos 49Recruiting
- General Hospital of Thessaloniki PapageorgiouRecruiting
- Hospital of Lithuanian University of Health Sciences Kauno klinikos
- Klaipeda Children's HospitalRecruiting
- Vilnius University Hospital Santaros KlinikosRecruiting
- Hospital Civil de Guadalajara Hospital 278, El retiro, Torre Piso 10, Infectología Ped.Recruiting
- Instituto Nacional de Pediatría "Laboratorio de la Unidad de Apoyo a la Investigación Clínica", Planta Baja Col. Insurgentes Cuicuilco, Delegacion Coyoacán Av. Insurgentes Sur 3700-CRecruiting
- Hospital de Especialidades Ped Via España y Calle ZarakRecruiting
- Hospital del Niño, EpidemiologiaRecruiting
- Chong Hua HospitalRecruiting
- Western Visayas and Medical CenterRecruiting
- Manila Doctor's Hospital
- Hospital Val d'HebronRecruiting
- Hospital del Mar, Passeig Marítim 25-29
- Municipal Noncommercial Enterprise of Kharkiv Regional Council " V.I.Shapoval Regional Clinical Center of Urology and Nephrology", Department of Children Urology # 7
- Vinnytsia Regional Children's Hospital
- Zaporizhzhia Regional Children Clinical Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Single Dose Phase: Cefiderocol
Multiple Dose Phase: Cefiderocol
Multiple Dose Phase: Standard of Care Alone
Participants will receive a single dose of cefiderocol administered intravenously (IV) on Day 1, in addition to standard of care. Participants weighing less than 34 kilograms (kg) will receive 60 milligrams (mg)/kg cefiderocol and participants ≥34 kg will receive 2000 mg.
Participants will receive cefiderocol administered via IV every 8 hours for an expected 5 to 14 days in addition to standard of care. Participants weighing less than 34 kg will receive 60 mg/kg cefiderocol and participants ≥ 34 kg will receive 2000 mg. Dosage may be adjusted based on renal function.
Participants will receive standard of care treatment according to local standards.