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Finding the Optimal Regimen for Mycobacterium Abscessus Treatment
Sponsor: The University of Queensland
Summary
Mycobacterium abscessus (MABS) is a group of rapid-growing, multi-drug resistant non-tuberculous mycobacteria (NTM) causing infections in humans. MABS pulmonary disease (MABS-PD) can result in significant morbidity, increased healthcare utilisation, accelerated lung function decline, impaired quality of life, more challenging lung transplantation, and increased mortality. While the overall numbers affected is small, the prevalence of infections is increasing worldwide. The Finding the Optimal Regimen for Mycobacterium abscessus Treatment (FORMaT) trial aims to produce high quality evidence for the best treatment regimens to maximise health outcomes and minimise toxicity and treatment burden, as well as developing biomarkers (serology, gene expression signatures, and radiology) to guide decisions for starting treatment and measuring disease severity in patients with MABS PD.
Official title: Finding the Optimal Regimen for Mycobacterium Abscessus Treatment (FORMaT)
Key Details
Gender
All
Age Range
Any - Any
Study Type
INTERVENTIONAL
Enrollment
300
Start Date
2020-03-02
Completion Date
2030-06-30
Last Updated
2025-08-13
Healthy Volunteers
No
Interventions
Amikacin
Adults: Intravenous amikacin 5mg/kg once daily or 7.5mg/kg twice daily or 20-25 mg/kg thrice weekly. Children:Intravenous amikacin 15-30 mg/kg once daily, maximum dose 1500mg
Tigecycline
Adults: Intravenous Tigecycline 25 mg increasing by 5 mg every two doses until either maximum dose reached (50mg) or until patient is unable to tolerate twice daily. Children (≥8 years of age) intravenous tigecycline: Day 1- 0.6mg/kg twice daily to a maximum of 25mg. Day 2- 0.6mg/kg (maximum 25mg) in the morning, 1.2 mg/kg (maximum 50mg) at night. Day 3- 1.2mg/kg (maximum 50 mg) twice daily
Imipenem
Adults: Intravenous Imipenem (≥50kg) 500mg twice daily (\<50kg) 15 mg/kg twice daily. Children: intravenous imipenem Day 1- 2- 25mg/kg (maximum 1g) twice daily. DAY 3- 25mg/kg (maximum 1g) four times daily (drop to 3 if not tolerated).
Cefoxitin
Adults: If imipenem is poorly tolerated intravenous cefoxitin 200 mg/kg thrice daily. Children: if imipenem is poorly tolerated intravenous cefoxitin 50mg/kg (maximum 4g) four times daily.
Azithromycin
Adults: Oral azithromycin 500mg (≥40kg) once daily, (\<40kg) 250mg once daily.During consolidaiton: 500mg (≥40kg) thrice weekly, (\<40kg) 250mg thrice weekly. Children: Oral azithromycin:10mg/kg (maximum 500mg) once daily. During consolidation 10mg/kg once daily maximum 500mg.
Clarithromycin
Adult: If azithromycin is poorly tolerated use oral clarithromycin 500mg twice daily.Children: If azithromycin is poorly tolerated use oral clarithromycin. In children 1 month old- 11years of age the following dosing applies: \<8kg: 7.5mg/kg twice daily, maximum dose 62.5mg, 8-11kg: 62.5mg twice daily, maximum dose 62.5mg, 12-19 kg: 125mg twice daily, maximum dose 125mg, 20-29 kg: 187.5mg twice daily, maximum dose 187.5mg, 30-40 kg: 250mg twice daily, maximum dose 250mg, Children 12-18 years of age: 500 mg twice daily
Clofazimine
Adult: Oral clofazimine 100mg once daily. Children: Oral clofazimine: 3-5mg/kg once daily. Maximum dose of 50mg once daily if \<40kg or 100mg if ≥40kg once daily.
Ethambutol
Adults: with confirmed mixed NTM infections (slow growers + MABS) oral ethambutol can be added at either 15 mg/kg once daily or 25mg/kg thrice weekly. Children with confirmed mixed NTM infections (slow growers + MABS) oral ethambutol can be added at 20 mg/kg once daily.
Amikacin
adult: Inhaled amikacin 500mg twice daily. Children: Inhaled amikacin 500mg twice daily
Linezolid
Adult: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin, bedaquiline or rifabutin) guided by participant susceptibility and tolerance. Oral linezolid 600mg once daily. Children: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin or rifabutin) guided by participant susceptibility and tolerance. Age 1 week - 9 years 10mg/kg twice daily maximum dose of 300mg. Age 10-12 years 10mg/kg twice daily maximum dose of 600mg. \>12 years 600mg once daily.
co-trimoxazole
Adult: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin, bedaquiline or rifabutin) guided by participant susceptibility and tolerance. Oral Co-trimoxazole (TMP-SMX) 160/800mg twice daily. Children: During consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin or rifabutin) guided by participant susceptibility and tolerance. Oral co-trimoxazole 5mg TMP/kg maximum dose of 160mg TMP/ 800mg SMX twice daily.
Doxycycline
Adult: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin, bedaquiline or rifabutin) guided by participant susceptibility and tolerance. Oral doxycycline 100mg once daily. Children: During consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin or rifabutin) guided by participant susceptibility and tolerance. Oral doxycycline (ages ≥ 8 years) 2mg/kg once daily maximum dose 100mg.
Moxifloxacin
Adult: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin, bedaquiline or rifabutin) guided by participant susceptibility and tolerance. Oral moxifloxacin 400mg once daily. Children: During consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin or rifabutin) guided by participant susceptibility and tolerance. Oral moxifloxacin 10-15mg/kg once daily, maximum dose 400mg
Bedaquiline
Adult: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin, bedaquiline or rifabutin) guided by participant susceptibility and tolerance. Oral bedaquiline (18-64 years of age) 400mg once daily for the first two weeks followed by 400mg thrice weekly for 22 weeks (maximum duration of 6 months).
Rifabutin
Adult: during consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin, bedaquiline or rifabutin) guided by participant susceptibility and tolerance. Oral rifabutin: 5mg/kg once daily, maximum 300-450mg. Children: During consolidation in combination with one to three oral antibiotics (co-trimoxazole, doxycycline, moxifloxacin or rifabutin) guided by participant susceptibility and tolerance. Oral rifabutin 5mg/kg once daily
Locations (50)
St George Hospital
Kogarah, New South Wales, Australia
Queensland Children's Hospital
South Brisbane, Queensland, Australia
Princess Alexandra Hospital
Woolloongabba, Queensland, Australia
Austin Hospital
Heidelberg, Victoria, Australia
Royal Melbourne Hospital
Parkville, Victoria, Australia
Royal Perth Hospital
Perth, Western Australia, Australia
Royal Adelaide Hospital
Adelaide, Australia
Sunshine Coast University Hospital
Birtinya, Australia
Royal Prince Alfred Hospital
Camperdown, Australia
The Prince Charles Hospital
Chermside, Australia
Gold Coast University Hospital
Gold Coast, Australia
Greenslopes Private Hospital,
Greenslopes, Australia
Sir Charles Gairdiner Hospital
Nedlands, Australia
John Hunter Hospital
New Lambton, Australia
John Hunter Children's Hospital
New Lambton Heights, Australia
Perth Children's Hospital
Perth, Australia
The Alfred
Prahran, Australia
Sydney Children's Hospital
Randwick, Australia
Mater Adult Hospital
South Brisbane, Australia
Macquarie University Hospital
Sydney, Australia
The Children's Hospital at Westmead
Westmead, Australia
Westmead Hospital
Westmead, Australia
Rigshospitalet
Copenhagen, Denmark
Soroka Medical Centre
Beer-Sheeva, Israel
Carmel Medical Centre
Haifa, Israel
Rambam Health Care Campus
Haifa, Israel
Hadassah Ein Kerem Hospital
Jerusalem, Israel
Schneider
Petah Tikva, Israel
Sheba Medical Centre
Ramat Gan Tel Aviv, Israel
Erasmus MC Sophia Children's Hospital
Rotterdam, Netherlands
Tan Tock Seng Hospital Pte Ltd
Singapore, Singapore
Kaohsiung Medical University Hospital
Kaohsiung City, Taiwan
National Taiwan University Hospital
Taipei, Taiwan
Belfast City Hospital
Belfast, United Kingdom
Birmingham Children's Hospital
Birmingham, United Kingdom
Birmingham Heartlands Hospital
Birmingham, United Kingdom
Bristol Royal Hospital for Children
Bristol, United Kingdom
Noah's Ark Childrens Hospital for Wales
Cardiff, United Kingdom
Royal Hospital for Children and Young People, Edinburgh
Edinburgh, United Kingdom
Western General Hospital
Edinburgh, United Kingdom
Queen Elizabeth University Hospital, Glasgow
Glasgow, United Kingdom
Alder Hey Children NHS Foundation Trust
Liverpool, United Kingdom
Royal Brompton Hosptial
London, United Kingdom
Royal Manchester Children's Hospital
Manchester, United Kingdom
Nottingham Children's Hosptial
Nottingham, United Kingdom
Queens Medical Centre
Nottingham, United Kingdom
Welcome Wolfson Adult CF Centre (City Hospital Campus)
Nottingham, United Kingdom
University Hospital Llandough
Penarth, United Kingdom
Southampton General Hospital
Southampton, United Kingdom
Wythenshawe Hospital
Wythenshawe, United Kingdom