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NICU Antibiotics and Outcomes Trial
Sponsor: Michael Morowitz
Summary
The goal of the NANO trial is to study the longstanding clinical practice of empirically administering intravenous antibiotics to extremely low birthweight (ELBW) infants in the first days of life. In this 802-subject multicenter placebo-controlled randomized clinical trial, the hypothesis to be tested is that the incidence of adverse outcomes is higher in babies receiving empiric antibiotics (EA) in the first week of life compared to babies receiving placebo. The study targets a population of ELBW infants in whom the clinical decision to use or not use EA is currently most challenging -- infants that are clinically stable that did not have a known exposure to intraamniotic infection and were not born preterm for maternal indications. The primary outcome is the composite outcome of late-onset sepsis (LOS), necrotizing enterocolitis (NEC), or death during the index hospitalization. Secondary safety outcomes will include total antibiotic days, days to full enteral feedings, and common morbidities in preterm infants that have previously been linked to EA, e.g. retinopathy of prematurity and bronchopulmonary dysplasia. Weight and length z-score, and head circumference, are standard measures to be collected weekly by clinical team per a standardized protocol.
Key Details
Gender
All
Age Range
Any - 4 Hours
Study Type
INTERVENTIONAL
Enrollment
802
Start Date
2020-08-05
Completion Date
2027-06-01
Last Updated
2025-09-23
Healthy Volunteers
No
Conditions
Interventions
Ampicillin
Intravenous ampicillin
Gentamycin
Intravenous gentamycin
Normal saline
Intravenous normal saline
Locations (14)
USA Children's and Women's Hospital
Mobile, Alabama, United States
Sharp Mary Birch Hospital for Women & Newborns
San Diego, California, United States
Yale University School of Medicine
New Haven, Connecticut, United States
University of South Flordia Health
Tampa, Florida, United States
University of Louisville Research Foundation Inc./Kosair Charities Pediatric Clinical Research Unit
Louisville, Kentucky, United States
The Trustees of Columbia University in the City of New York
New York, New York, United States
Golisano Children's Hospital at University of Rochester
Rochester, New York, United States
Maria Fareri Children's Hospital at Westchester Medical Center
Valhalla, New York, United States
Atrium Health Wake Forest Baptist
Winston-Salem, North Carolina, United States
Penn State Medical College
Hershey, Pennsylvania, United States
Pennsylvania Hospital/The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Alfred I. duPont for Children of the Nemours Foundation
Philadelphia, Pennsylvania, United States
Magee Womens Hospital
Pittsburgh, Pennsylvania, United States
University of Texas Health Science Center at San Antonio
San Antonio, Texas, United States