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Trial registered on ANZCTR
Registration number
ACTRN12617001528347
Ethics application status
Approved
Date submitted
31/10/2017
Date registered
3/11/2017
Date last updated
28/10/2021
Date data sharing statement initially provided
28/10/2021
Date results provided
28/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The use of antibiotics in elective non-hysterectomy gynaecological laparoscopy for benign procedures
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Scientific title
Antibiotic Prophylaxis in Benign Gynaecological Laparoscopic Surgery
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Secondary ID [1]
293245
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Nil known
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Universal Trial Number (UTN)
U1111-1204-4989
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Benign Gynaecological Laparoscopic Surgery
305293
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Condition category
Condition code
Infection
304598
304598
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0
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Studies of infection and infectious agents
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Surgery
304606
304606
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
2g intravenous Cephazolin made into a 10ml solution, given within 30min prior to the beginning of Laparoscopic Surgery
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Intervention code [1]
299507
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Prevention
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Intervention code [2]
299513
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Treatment: Drugs
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Comparator / control treatment
10ml injection of normal saline, given within 30min prior to the beginning of laparoscopic surgery
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Control group
Placebo
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Outcomes
Primary outcome [1]
303823
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The post-operative infections rates. Patients will be encouraged to seek assistance if any concerns about an infection. Surgical site infection will be diagnosed clinically by the treating team or a primary care doctor (e.g. general practitioner or emergency physician) although wound swabs are encouraged to confirm diagnosis and type of bacteria.
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Assessment method [1]
303823
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Timepoint [1]
303823
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6 weeks post-operative
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Primary outcome [2]
303833
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Study feasibility. This will be assessed by recruitment rates of potential research participants, the rates of unblinding of treatment allocation to the patient or treating team, and rates of follow-up at 6 weeks post-partum.
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Assessment method [2]
303833
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Timepoint [2]
303833
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Up to 6 weeks
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Secondary outcome [1]
340224
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Antibiotic related reactions. These will be identified clinically at the time of surgery as anaphylaxis or skin reactions such as urticaria, rash, exanthem and pruritis
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Assessment method [1]
340224
0
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Timepoint [1]
340224
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Within 30min post antibiotic administration
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Secondary outcome [2]
340225
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Re-admission to hospital. Patients will be provided with a letter of participation which will include the participant number and contact details for the research team. The letter will ask that treating doctors contact the surgical team directly if any infection occurs requiring admission to hospital. For suspected infections not requiring admission to hospital, treating doctors will be requested to provide a discharge or summary letter from the consultation to bring to their 6 week appointment.
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Assessment method [2]
340225
0
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Timepoint [2]
340225
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Up to 6 weeks post-operatively
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Secondary outcome [3]
340226
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Length of hospital stay
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Assessment method [3]
340226
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Timepoint [3]
340226
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Till time of discharge
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Eligibility
Key inclusion criteria
1. Patients requiring an elective laparoscopic procedure (that does not include hysterectomy) for a benign gynaecological condition as determined jointly by the surgeon and the patient.
2. English speaking.
3. Over 18 years of age at time of surgery.
4. Patients who understand the conditions of the study and are willing to participate for the length of the prescribed term of follow-up.
5. Patients who are capable of, and have given, informed consent to their participation in the study.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Pregnant women.
2. Immunocompromised patients.
3. Patients with a documented history of cephalosporin allergy
4. Patients with a documented history of major penicillin allergy
5. Current involvement in any other research project.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generator
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
All data from the Case-Report Forms will be entered into an electronic database. Data will be analysed using SPSS (v X2 SPSS Inc, Chicago Ill). Feasibility will be determined by rates of cases completed without accidental unblinding and analysis of adverse events in each group. Analysis of all primary and secondary outcome measures will be on an intention-to-treat basis although it is not expected to reach significance in this pilot trial. Demographic data will be compared using appropriate parametric and non-parametric statistical tests following the assessment of the distribution of the data by the Kolgarov-Smirnov method. Categorical data such as the presence or absence of infection will be compared using a Chi-square test with Fischer’s exact test where appropriate.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
5/02/2019
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Actual
21/02/2019
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Date of last participant enrolment
Anticipated
6/11/2019
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Actual
16/03/2021
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Date of last data collection
Anticipated
20/12/2020
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Actual
22/04/2021
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Sample size
Target
150
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Accrual to date
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Final
117
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
9302
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Royal Hospital for Women - Randwick
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Recruitment postcode(s) [1]
17967
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2031 - Randwick
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Funding & Sponsors
Funding source category [1]
297874
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Charities/Societies/Foundations
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Name [1]
297874
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Australasian Gynaecological Endoscopy and Surgery Society
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Address [1]
297874
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PO Box 717
Indooroopilly
QLD 4068
AUSTRALIA
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Country [1]
297874
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Australia
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Primary sponsor type
Hospital
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Name
Royal Hospital for Women
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Address
Barker St,
Randwick NSW 2031
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Country
Australia
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Secondary sponsor category [1]
296921
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None
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Name [1]
296921
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Address [1]
296921
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Country [1]
296921
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298924
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South Eastern Sydney Local Health District
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Ethics committee address [1]
298924
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Research Support Office G71, East Wing Edmund Blacket Building Prince of Wales Hospital Randwick NSW 2031
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Ethics committee country [1]
298924
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Australia
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Date submitted for ethics approval [1]
298924
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09/10/2017
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Approval date [1]
298924
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31/10/2017
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Ethics approval number [1]
298924
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Summary
Brief summary
Surgical site infections are recognised as a common surgical complication, and the use of antibiotic prophylaxis has become an important method of reducing the risk of infection. However, given increasing concerns regarding antibiotic resistance, it is important that the use of antibiotic prophylaxis be evidence based. Local and international guidelines attempt to aid clinicians by outlining the evidence available for prophylaxis for various gynaecological procedures. The current Australian Therapeutic Guidelines recommend antibiotic prophylaxis for hysterectomy, termination of pregnancy and caesarean delivery, with no specific reference to non-hysterectomy complex laparoscopic procedures. Although anaphylactic reactions to cephalosporins are reported to be rare (0.001 to 0.1%), skin reactions such as urticaria, rash, exanthem and pruritis occur in 1-3% of patients. Other reported reactions include serum-sickness-like reaction, fever and immunohematologic reactions. Additionally, the potential costs of antibiotic resistance mean all clinicians have a heightened responsibility to ensure administration of antibiotics is for appropriate indications. Medicare data shows that at least 25000 non-hysterectomy, operative laparoscopic gynaecological procedures were performed in Australia last year. In view of the frequency with which such surgery is performed, there is a clear need for an appropriately powered study to examine whether there is a role for antibiotic prophylaxis for non-hysterectomy laparoscopic surgery in gynaecology. To ensure this a study of this magnitude can be carried out correctly, it is essential to perform this pilot study to assess the feasibility of future studies. Given the potential costs to both patients and the health-care system of post-operative infectious morbidity, as well as the costs of using antibiotics, including the actual cost of drug administration, adverse reactions in individual patients, and potential increases in antibiotic resistance, the results of this study have the potential to significantly impact both local and international policy in this area.
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Trial website
No Website
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Trial related presentations / publications
Nil
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Public notes
Nil
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Contacts
Principal investigator
Name
78666
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A/Prof Jason Abbott
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Address
78666
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Royal Hospital for Women
Barker Street, Randwick, NSW 2031
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Country
78666
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Australia
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Phone
78666
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+61293826111
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Fax
78666
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Email
78666
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[email protected]
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Contact person for public queries
Name
78667
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Jason Abbott
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Address
78667
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Royal Hospital for Women
Barker Street, Randwick, NSW 2031
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Country
78667
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Australia
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Phone
78667
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+61293826111
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Fax
78667
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Email
78667
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[email protected]
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Contact person for scientific queries
Name
78668
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Jason Abbott
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Address
78668
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Royal Hospital for Women
Barker St, Randwick, NSW 2031
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Country
78668
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Australia
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Phone
78668
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+61293826111
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Fax
78668
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Email
78668
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Outcome data (deidentified).
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When will data be available (start and end dates)?
September 30th 2021 start - September 30th 2026
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Available to whom?
Researchers for meta-analyses. Scientific validation
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Available for what types of analyses?
Meta-analyses
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How or where can data be obtained?
To be updated once data repository link finalised
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
13848
Study protocol
[email protected]
13849
Statistical analysis plan
[email protected]
13850
Ethical approval
[email protected]
13851
Informed consent form
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF