ISRCTN ISRCTN86140460
DOI https://doi.org/10.1186/ISRCTN86140460
Secondary identifying numbers 077166
Submission date
23/11/2005
Registration date
23/11/2005
Last edited
19/06/2015
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Ploenchan Chetchotsakd
Scientific

Khon Kaen University
Department of Medicine
Faculty of Medicine
Srinagarind Hospital
Mitrapharp Highways
Khon Kaen
40002
Thailand

Phone +66 (0)4 3363168
Email ploencha@kku.ac.th

Study information

Study designPlacebo-controlled randomised multicentre study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleA comparison of doxycycline plus trimethoprim-sulphamethoxazole versus trimethoprim-sulphamethoxazole as maintenance therapy for melioidosis
Study acronymMERTH
Study objectivesTo evaluate the efficacy, effectiveness and compliance of Trimethoprim-Sulphamethoxazole (TMP-SMX) compared with doxycycline, Trimethoprim (TMP), and Sulphamethoxazole (SMX) in the oral maintenance phase treatment of melioidosis.
Ethics approval(s)1. The Ethical Review Committee for Research in Human Subjects, Ministry of Public Health, Thailand (IRB00001629), 27/07/2005, ref: 67/2548
2. The Khon Kaen University Ethics Committee (IRB00001189), 20/05/2005, ref: HE7471005
3. The Oxford Tropical Research Ethics Committee (OXTREC), 04/11/2005, ref: 021-05
Health condition(s) or problem(s) studiedMelioidosis
InterventionThe patients will be randomised into two groups, and the randomisation will be performed in advance by blocks of ten. Pre-prepared treatment-containing packs will be labelled with the consecutive study numbers. The study drugs include either of the combinations below:

1. Three drugs:
a. Co-trimoxazole (10 mg TMP and 50 mg SMX/kg/day): three adult tablets (80 mg TMP/tab), twice daily. The dose of co-trimoxazole will be reduced to two tablets, twice daily in case of patients with creatinine clearance less than 30 ml/min or who weigh less than 35 kg, and increased to four tablets, twice daily in case of patients who weigh more than 65 kg.
b. Doxycycline (4 mg/kg/day): one tablet twice daily.

2. Two drugs:
a. Co-trimoxazole (10 mg TMP and 50 mg SMX/kg/day): three adult tablets (80 mg TMP/tab), twice daily. The dose of co-trimoxazole will be reduced to two tablets, twice daily in case of patients with creatinine clearance less than 30 ml/min or who weigh less than 35 kg, and increased to four tablets, twice daily in case of patients who weigh more than 65 kg.
b. Placebo (identical tablet as doxycycline): one tablet twice daily.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Co-trimoxazole (Trimethoprim and sulphamethoxazole), doxycycline
Primary outcome measure1. Mortality
2. Recurrent disease: this is defined as clinical features of melioidosis after initial improvement, in association with cultures from any site positive for Burkholderia pseudomallei. This can be any time point during or after stopping antibiotic treatment.
Secondary outcome measures1. Clinical recurrence: recurrent clinical features of melioidosis treated as such but not confirmed by positive culture
2. Treatment failure: clinical decision to change treatment according to inadequate response to therapy
3. Adverse drug reactions, including drug allergy
4. Drug compliance: based on interview and pill counting
Overall study start date26/10/2005
Completion date31/10/2009

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participants600
Key inclusion criteria1. Culture-confirmed melioidosis
2. Satisfactory completion of intravenous therapy and able to take oral medication
3. Patients with mild localised disease who are not considered to require intravenous treatment by their primary physician are eligible if they agree to return for follow up
5. Aged over 14 years, either sex
6. High likelihood of completing at least six months follow up
7. Willingness to participate in the study and written, informed consent obtained from the patient
Key exclusion criteria1. Pregnancy or breast feeding
2. Contraindications to doxycycline: severe hepatic impairment (aspartate aminotransferase [AST], alanine aminotransferase [ALT] more than or equal to five times of upper limit of normal)
3. Contraindications to TMP-SMX: Glucose-6-phosphate dehydrogenase (G6PD) deficiency, renal impairment (creatinine clearance less than 15 ml/min)
4. History of hypersensitivity to doxycycline, TMP or SMX
5. Infecting isolate is resistant to TMP-SMX by E-test
6. Relapse melioidosis with disease free interval of less than two years
Date of first enrolment26/10/2005
Date of final enrolment31/10/2008

Locations

Countries of recruitment

  • Thailand

Study participating centre

Khon Kaen University
Khon Kaen
40002
Thailand

Sponsor information

Khon Kaen University (Thailand)
University/education

Department of Medicine
Faculty of Medicine
Srinagarind Hospital
Mitrapharp Highways
Khon Kaen
40002
Thailand

Website http://www.kku.ac.th/eng/index.html
ROR logo "ROR" https://ror.org/03cq4gr50

Funders

Funder type

Charity

Wellcome Trust (UK) (grant ref: 077166)
Private sector organisation / International organizations
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/03/2014 Yes No