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Efficacy and Safety of BIO-K + CL1285 in Prevention of Antibiotic-associated Diarrhea in Hospitalized Adult Patients

Primary Purpose

Diarrhea, Clostridium Infections

Status
Completed
Phase
Phase 3
Locations
Canada
Study Type
Interventional
Intervention
Lactobacillus acidophilus CL1285 and Lactobacillus casei
placebo
Sponsored by
Bio-K Plus International Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Diarrhea focused on measuring Bio-K+CL1285, Probiotics, Antibiotics-associated diarrhea, Clostridium difficile-associated diarrhea, Lactobacillus acidophilus, Clostridium Difficile

Eligibility Criteria

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

Inclusion Criteria: presenting to the Emergency Room and considered for admission to hospital for a minimum of 12 hours and requiring antibiotic administration for the treatment of a suspected or proven bacterial infection OR a hospitalized patient developing a suspected or proven nosocomial infection OR an external patient that come to the hospital for repeated visits to receive his intravenous antibiotic therapy for the treatment of a suspected or proven bacterial infection. The external patients on oral antibiotics that come to the hospital for repeated visits to receive any other treatments requiring a hospital stay of more than one hour will also be included. Hospital employee on antibiotics can also be included in the study having received less than 24 hours of antibiotic therapy; requiring a minimum of 3 days and a maximum of 14 days antibiotic administration Informed consent must be obtained in writing for all subjects at enrollment into the study Exclusion Criteria: Subjects presenting with any of the following will not be included in the study: active diarrhea; a history of daily consumption of fermented milk and/or yogurt; intolerance to lactose; pregnant/breastfeeding women; an active, non controlled intestinal disease such as Crohn's Disease or ulcerative colitis; ileostomy, jejunostomy or colostomy; immunosuppressed state; a previous documented C. difficile infection in the three months prior to study initiation; active radiotherapy or chemotherapy; recent (< 6 months) or planned bone marrow graft or organ transplant; antibiotic therapy in the fourteen days prior to study initiation; the planned administration of metronidazole (alone or in combination) or vancomycin monotherapy for the treatment of an infection; mental or other conditions, or language barriers rendering the subject unable to understand the nature, scope, and possible consequences of the study or complete the self-administered questionnaires; subject unlikely to comply with protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study. Post-enrollment exclusion criteria include fermented milk and/or yogurt consumption during the study period and two consecutive missed dose of study product.

Sites / Locations

  • Hamilton General Hospital
  • Kingston General Hospital
  • North York General Hospital
  • Hotel Dieu de Chicoutimi
  • St-Mary Hospital Center
  • Hotel-Dieu de St-Jerome
  • Centre Hospitalier Régional de Trois-Rivières
  • Laval Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

1

2

Arm Description

Bio-K Cl1285 Bio-K Cl1285 contains 50 billion of live bacteria.

placebo devoid of bacteria

Outcomes

Primary Outcome Measures

The Incidence of Antibiotic-associated Diarrhea.
Presence of at least one diarrhea episode within 24 hours.

Secondary Outcome Measures

Positive Results for Clostridium Difficile (C. Difficile) Toxin A or B in Antibiotic Associated Diarrhea Patients.
Testing for CDAD was performed at the discretion of the treating physician and according to the protocol in place at the study centers. CDAD was defined as an episode of diarrhea and positive results for C. difficile Toxin A or B.
Health Outcome Evaluation Will Look at the Direct Medical Costs and Clinical Outcomes of Alternative Strategies in the Prevention of Antibiotic-associated Diarrhea in Hospitalized Adult Patients
Safety Profile of BIO-K+CL1285® Versus Placebo in Patients on Antibiotics
Safety was assessed by the incidence of treatment-emerged adverse events, which were reported according to MedDRA 10.1

Full Information

First Posted
May 17, 2006
Last Updated
July 15, 2014
Sponsor
Bio-K Plus International Inc.
Collaborators
JSS Medical Research Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00328263
Brief Title
Efficacy and Safety of BIO-K + CL1285 in Prevention of Antibiotic-associated Diarrhea in Hospitalized Adult Patients
Official Title
A Double-blind, Randomized, Placebo Controlled, Multicenter Study of the Efficacy and Safety of BIO-K*+ CL-1285* in the Prevention of Antibiotic-associated Diarrhea in Adult Patients Exposed to Nosocomial Infection.
Study Type
Interventional

2. Study Status

Record Verification Date
July 2014
Overall Recruitment Status
Completed
Study Start Date
March 2006 (undefined)
Primary Completion Date
March 2007 (Actual)
Study Completion Date
October 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bio-K Plus International Inc.
Collaborators
JSS Medical Research Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy and safety of Bio-K + CL1285 versus placebo in the prevention of antibiotic-associated diarrhea in hospitalized adult patients.
Detailed Description
Antibiotic-associated diarrhea (AAD) is one of the most frequent adverse events following antibiotherapy and is the leading cause of diarrhea in hospitalized patients. Ten to 25% of AAD are caused by the bacteria Clostridium difficile. A recent unicenter study conducted at Maisonneuve-Rosemont hospital demonstrated the preventive role of Bio-K + CL1285 in antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea. Its preventive role is thought to be mainly through restoration of the gastrointestinal flora affected in part by the antibiotherapy. A wide body of literature reveals clinical use of probiotics, but few well controlled prospective studies conducted on large numbers of subjects have been performed. In light of the positive preliminary results obtained in a limited number of patients with AAD and of the paucity of well controlled clinical trials, we now wish to undertake a randomized, double blind, multicentre study to evaluate the efficacy and safety of Bio-K + CL1285 prophylaxis vs. placebo in the prevention of antibiotic-associated diarrhea in hospitalized adult patients. As secondary objectives, we also intend to evaluate the incidence of Clostridium difficile-associated diarrhea and to demonstrate that BIO-K + CL1285 agent will not only improve the clinical outcomes but also reduce health care expenditures.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea, Clostridium Infections
Keywords
Bio-K+CL1285, Probiotics, Antibiotics-associated diarrhea, Clostridium difficile-associated diarrhea, Lactobacillus acidophilus, Clostridium Difficile

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
472 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Bio-K Cl1285 Bio-K Cl1285 contains 50 billion of live bacteria.
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
placebo devoid of bacteria
Intervention Type
Dietary Supplement
Intervention Name(s)
Lactobacillus acidophilus CL1285 and Lactobacillus casei
Other Intervention Name(s)
BioK CL1285
Intervention Description
One bottle daily 2 hours before or after antibiotic administration and for 5 days following the termination of antibiotic regimen.
Intervention Type
Dietary Supplement
Intervention Name(s)
placebo
Intervention Description
One bottle daily 2 hours before or after antibiotic administration and for 5 days following the termination of antibiotic regimen.
Primary Outcome Measure Information:
Title
The Incidence of Antibiotic-associated Diarrhea.
Description
Presence of at least one diarrhea episode within 24 hours.
Time Frame
Up to 40 days
Secondary Outcome Measure Information:
Title
Positive Results for Clostridium Difficile (C. Difficile) Toxin A or B in Antibiotic Associated Diarrhea Patients.
Description
Testing for CDAD was performed at the discretion of the treating physician and according to the protocol in place at the study centers. CDAD was defined as an episode of diarrhea and positive results for C. difficile Toxin A or B.
Time Frame
Up to 40 days
Title
Health Outcome Evaluation Will Look at the Direct Medical Costs and Clinical Outcomes of Alternative Strategies in the Prevention of Antibiotic-associated Diarrhea in Hospitalized Adult Patients
Time Frame
Up to 40 days
Title
Safety Profile of BIO-K+CL1285® Versus Placebo in Patients on Antibiotics
Description
Safety was assessed by the incidence of treatment-emerged adverse events, which were reported according to MedDRA 10.1
Time Frame
Up to 40 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: presenting to the Emergency Room and considered for admission to hospital for a minimum of 12 hours and requiring antibiotic administration for the treatment of a suspected or proven bacterial infection OR a hospitalized patient developing a suspected or proven nosocomial infection OR an external patient that come to the hospital for repeated visits to receive his intravenous antibiotic therapy for the treatment of a suspected or proven bacterial infection. The external patients on oral antibiotics that come to the hospital for repeated visits to receive any other treatments requiring a hospital stay of more than one hour will also be included. Hospital employee on antibiotics can also be included in the study having received less than 24 hours of antibiotic therapy; requiring a minimum of 3 days and a maximum of 14 days antibiotic administration Informed consent must be obtained in writing for all subjects at enrollment into the study Exclusion Criteria: Subjects presenting with any of the following will not be included in the study: active diarrhea; a history of daily consumption of fermented milk and/or yogurt; intolerance to lactose; pregnant/breastfeeding women; an active, non controlled intestinal disease such as Crohn's Disease or ulcerative colitis; ileostomy, jejunostomy or colostomy; immunosuppressed state; a previous documented C. difficile infection in the three months prior to study initiation; active radiotherapy or chemotherapy; recent (< 6 months) or planned bone marrow graft or organ transplant; antibiotic therapy in the fourteen days prior to study initiation; the planned administration of metronidazole (alone or in combination) or vancomycin monotherapy for the treatment of an infection; mental or other conditions, or language barriers rendering the subject unable to understand the nature, scope, and possible consequences of the study or complete the self-administered questionnaires; subject unlikely to comply with protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study. Post-enrollment exclusion criteria include fermented milk and/or yogurt consumption during the study period and two consecutive missed dose of study product.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joe S Dylewski, MD
Organizational Affiliation
St-Mary Hospital Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hamilton General Hospital
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8L-2X2
Country
Canada
Facility Name
Kingston General Hospital
City
Kingston
State/Province
Ontario
ZIP/Postal Code
K7L 2V7
Country
Canada
Facility Name
North York General Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M2K 1E1
Country
Canada
Facility Name
Hotel Dieu de Chicoutimi
City
Chicoutimi
State/Province
Quebec
ZIP/Postal Code
G7H5H6
Country
Canada
Facility Name
St-Mary Hospital Center
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3T 1M5
Country
Canada
Facility Name
Hotel-Dieu de St-Jerome
City
St-Jerome
State/Province
Quebec
ZIP/Postal Code
J7Z 5T3
Country
Canada
Facility Name
Centre Hospitalier Régional de Trois-Rivières
City
Trois-Rivieres
State/Province
Quebec
ZIP/Postal Code
G8Z 3R9
Country
Canada
Facility Name
Laval Hospital
City
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada

12. IPD Sharing Statement

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Efficacy and Safety of BIO-K + CL1285 in Prevention of Antibiotic-associated Diarrhea in Hospitalized Adult Patients

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