21 Participants Needed

Single-Dose ZTI-01 for Pediatric Patients

(Pediatric_PK Trial)

Recruiting at 4 trial locations
SG
Overseen BySteve Gelone
Age: < 18
Sex: Any
Trial Phase: Phase 1
Sponsor: Nabriva Therapeutics AG
Must be taking: Antibiotics
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a single dose of ZTI-01, an antibiotic, in children under 12 who need treatment for bacterial infections. The goal is to understand how their bodies process the drug compared to adults, which can help determine the right dose for children. Children already receiving antibiotics for a known or suspected infection or for surgery preparation might be suitable candidates. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants a chance to be among the first to receive this new treatment.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you must be receiving standard antibiotics for a bacterial infection to participate.

Is there any evidence suggesting that this treatment is likely to be safe for humans?

Research has shown that fosfomycin, the main ingredient in ZTI-01, is very safe for children and is well-tolerated even with long-term use. Studies have found that fosfomycin can be safely combined with many other intravenous drugs, allowing it to be administered alongside other treatments. Although data on high doses is limited, existing evidence supports its safety in children. Overall, current studies and its use in other conditions consider fosfomycin safe.12345

Why do researchers think this study treatment might be promising?

Researchers are excited about ZTI-01 because it offers a fresh approach to treating bacterial infections in children using the active ingredient fosfomycin. Unlike many standard antibiotics, fosfomycin works by uniquely targeting bacterial cell wall synthesis, which can be effective against resistant strains. Additionally, ZTI-01 is administered as a single intravenous dose, potentially simplifying treatment and improving compliance compared to multi-dose regimens. This combination of a novel action mechanism and simplified delivery makes ZTI-01 a promising candidate in the fight against pediatric bacterial infections.

What evidence suggests that ZTI-01 might be an effective treatment for bacterial infections in pediatric patients?

Research has shown that ZTI-01, also known as fosfomycin for injection, effectively treats serious infections in children, particularly those caused by bacteria resistant to other treatments. It has successfully treated complicated urinary tract infections and pneumonia in both adults and children. Studies have found that fosfomycin works well against tough bacteria often resistant to other antibiotics. Although fosfomycin is mainly used for urinary tract infections, researchers are exploring its use for other serious infections due to its effectiveness. Early findings suggest that fosfomycin could be a valuable option for treating severe infections in children, offering a new way to combat resistant germs. Participants in this trial will receive a single dose of ZTI-01, with different cohorts based on age to evaluate its safety and effectiveness in pediatric patients.16789

Who Is on the Research Team?

JS

John S Bradley, MD

Principal Investigator

Rady Children's Hospital / Department of Pediatrics, University of California, School of Medicine

JS

Jennifer Schranz, MD

Principal Investigator

Nabriva Therapeutics

Are You a Good Fit for This Trial?

This trial is for children under 12 years old who are hospitalized and currently receiving antibiotics for a bacterial infection or as prevention around surgery. They must have normal organ function, not be at risk of pregnancy, and have proper intravascular access. Children with seizure disorders, significant lab abnormalities, known drug allergies, impaired kidney function, or certain viral infections cannot participate.

Inclusion Criteria

Has sufficient intravascular access to receive study drug through peripheral or central line
Signed consent/assent
If of reproductive potential, agrees to avoid becoming pregnant or impregnating a partner from the time of consent through 24 hours after completion of study drug administration
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Exclusion Criteria

I have not been in this trial or taken ZTI-01 or fosfomycin in the last 30 days.
I have surgery planned during the time my blood will be tested for fosfomycin levels.
Is currently participating in or has participated in an interventional clinical trial with an investigational compound or device within 30 days or 5 half-lives, or twice the duration of the biological effect of any drug (whichever is longer) of administration of the study drug
See 14 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive a single, weight-adjusted dose of ZTI-01 via continuous IV infusion or syringe pump over a 1-hour period

1 day
1 visit (in-person)

Follow-up

Participants are monitored for safety and pharmacokinetics, including blood collection for fosfomycin concentration measurement and assessment of adverse events

1 day
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • ZTI-01
Trial Overview The study tests how a single dose of ZTI-01 (an antibiotic) behaves in the bodies of children compared to adults. It's an open-label Phase 1 trial across multiple centers aiming to find the right pediatric dosage by scaling from an adult dose using weight-based calculations.
How Is the Trial Designed?
5Treatment groups
Experimental Treatment
Group I: ZTI-01 Cohort 3c ≥ 6 to < 24 mos of ageExperimental Treatment1 Intervention
Group II: ZTI-01 Cohort 3b ≥ 3 to < 6 mos of ageExperimental Treatment1 Intervention
Group III: ZTI-01 Cohort 3a Birth to < 3 mos of ageExperimental Treatment1 Intervention
Group IV: ZTI-01 Cohort 2 ≥ 2 to <6 years of ageExperimental Treatment1 Intervention
Group V: ZTI-01 Cohort 1 ≥ 6 to <12 years of ageExperimental Treatment1 Intervention

ZTI-01 is already approved in United States for the following indications:

🇺🇸
Approved in United States as ZTI-01 for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Nabriva Therapeutics AG

Lead Sponsor

Trials
10
Recruited
2,100+

Published Research Related to This Trial

Invasive fungal infections (IFIs) are a significant health risk for immunocompromised children, highlighting the need for effective prevention and treatment strategies.
Current antifungal treatments for pediatric patients are limited due to a lack of approved agents, established dosages for different age groups, and insufficient postmarketing safety and efficacy data.
Efficacy and safety of antifungals in pediatric patients.Groll, AH.[2019]
Pediatric patients have different pharmacokinetic parameters compared to adults, which means they need individualized medication dosing rather than just smaller doses of adult medications.
The lack of specific dosing guidelines and appropriate pediatric dosage forms can lead to serious dosing errors and complications, highlighting the need for tailored dosing strategies to ensure safety and efficacy in young patients.
Dosing considerations in the pediatric patient.Skaer, TL.[2013]
In a study involving 465 hospitalized adults with complicated urinary tract infections (cUTI) or acute pyelonephritis (AP), ZTI-01 (fosfomycin) demonstrated noninferiority to piperacillin-tazobactam, achieving a success rate of 64.7% compared to 54.5% for the comparator, indicating its effectiveness against serious Gram-negative infections.
ZTI-01 was well tolerated, with most side effects being mild and temporary, suggesting it is a safe treatment option for patients with cUTI and AP.
Fosfomycin for Injection (ZTI-01) Versus Piperacillin-tazobactam for the Treatment of Complicated Urinary Tract Infection Including Acute Pyelonephritis: ZEUS, A Phase 2/3 Randomized Trial.Kaye, KS., Rice, LB., Dane, AL., et al.[2020]

Citations

Fosfomycin in the pediatric setting: Evidence and potential ...The main indication for fosfomycin in pediatrics is currently community-acquired lower urinary tract infection.
PK Study of Single-Dose ZTI-01 in Children (<12 Years of ...Study will help establish pediatric dosing in younger children by age cohort. This is a multiple-center, open-label, PK study of ZTI-01 ( fosfomycin for ...
Fosfomycin for Injection (ZTI-01) Versus Piperacillin ...ZTI-01 was effective for treatment of cUTI including AP and offers a new IV therapeutic option with a differentiated MOA for patients with serious Gram-negative ...
Determining an appropriate fosfomycin (ZTI-01) dosing ...For P. aeruginosa pneumonia, a dose of 6 g q8h is recommended, with an even higher dose of 8 g q8h necessary for pneumonia patients.
5.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39231448/
Intravenous fosfomycin indications and treatment outcomes ...IV fosfomycin is an effective agent in treating severe pediatric infections caused by resistant microorganisms. Fosfomycin can be used in various indications.
Fosfomycin for injectionPediatrics (<12 years): Based on the limited data submitted and reviewed by Health Canada, the safety and efficacy of IVOZFO™ (fosfomycin ...
Single-Dose ZTI-01 for Pediatric Patients (Pediatric_PK Trial)Fosfomycin for injection demonstrated physical compatibility with 77% of the 95 intravenous drugs tested, indicating it can be safely co-administered with many ...
Pharmacokinetics, Safety, and Tolerability of Single-Dose ...The pharmacokinetics, safety, and tolerability of intravenous (i.v.) fosfomycin disodium (ZTI-01) and oral fosfomycin tromethamine were ...
Summary of Product CharacteristicsThere are limited safety data in particular for doses in excess of 16 g/day. ... Paediatric population. The pharmacokinetics of fosfomycin in ...
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