Trial Outcomes & Findings for Postoperative Antibiotic Management Duration Following Surgery for Intravenous Drug Abuse (IVDA) Endocarditis (OPTIMAL) (NCT NCT05156437)

NCT ID: NCT05156437

Last Updated: 2026-05-05

Results Overview

Incidences of all-cause mortality at six (6) months post-surgery.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

5 participants

Primary outcome timeframe

Six months

Results posted on

2026-05-05

Participant Flow

Participants were recruited from a population with substance use disorder and active or recent infective endocarditis requiring surgery. Recruitment and retention were difficult due to social instability, limited outpatient engagement, and challenges maintaining contact. Five participants enrolled, but all were lost to follow-up before completing therapy or reaching the first assessment, and no additional eligible participants could be retained.

Five participants were enrolled and assigned to two study arms (Group I: 4; Group II: 1). After surgery and treatment initiation, all were lost to follow-up before completing the six-week therapy period or reaching any follow-up visit, resulting in 0 completions. The only reason for non-completion was loss to follow-up; no participants withdrew consent, had adverse events, or were removed. All were classified as "Not Completed-Lost to Follow-up."

Participant milestones

Participant milestones
Measure
Group II (Control Group)
Conventional two (2) weeks of postoperative inpatient IV antibiotic therapy followed by four (4) weeks of IV antibiotic therapy (inpatient or facility supervised if indwelling catheter utilized). Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline: Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline
Group I (Experimental)
Two (2) weeks of postoperative inpatient IV antibiotic therapy followed by four (4) weeks of oral therapy with outpatient follow-up. Amoxycillin, Cefalexin, Dicloxacillin, Linezolid, Levofloxacin, Rifampicin: Amoxycillin, Cefalexin, Dicloxacillin, Linezolid, Levofloxacin, Rifampicin Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline: Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline
Overall Study
STARTED
1
4
Overall Study
COMPLETED
0
0
Overall Study
NOT COMPLETED
1
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Group II (Control Group)
Conventional two (2) weeks of postoperative inpatient IV antibiotic therapy followed by four (4) weeks of IV antibiotic therapy (inpatient or facility supervised if indwelling catheter utilized). Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline: Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline
Group I (Experimental)
Two (2) weeks of postoperative inpatient IV antibiotic therapy followed by four (4) weeks of oral therapy with outpatient follow-up. Amoxycillin, Cefalexin, Dicloxacillin, Linezolid, Levofloxacin, Rifampicin: Amoxycillin, Cefalexin, Dicloxacillin, Linezolid, Levofloxacin, Rifampicin Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline: Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline
Overall Study
Lost to Follow-up
1
4

Baseline Characteristics

Postoperative Antibiotic Management Duration Following Surgery for Intravenous Drug Abuse (IVDA) Endocarditis (OPTIMAL)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group I (Experimental)
n=4 Participants
Two (2) weeks of postoperative inpatient IV antibiotic therapy followed by four (4) weeks of oral therapy with outpatient follow-up. Amoxycillin, Cefalexin, Dicloxacillin, Linezolid, Levofloxacin, Rifampicin: Amoxycillin, Cefalexin, Dicloxacillin, Linezolid, Levofloxacin, Rifampicin Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline: Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline
Group II (Control Group)
n=1 Participants
Conventional two (2) weeks of postoperative inpatient IV antibiotic therapy followed by four (4) weeks of IV antibiotic therapy (inpatient or facility supervised if indwelling catheter utilized). Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline: Ampicillin, Oxacillin, Vancomycin, Daptomycin, Ceftriaxone, Cefepime, Ceftaroline
Total
n=5 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Age, Categorical
Between 18 and 65 years
4 Participants
n=54 Participants
1 Participants
n=60 Participants
5 Participants
n=114 Participants
Age, Categorical
>=65 years
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Sex: Female, Male
Female
4 Participants
n=54 Participants
0 Participants
n=60 Participants
4 Participants
n=114 Participants
Sex: Female, Male
Male
0 Participants
n=54 Participants
1 Participants
n=60 Participants
1 Participants
n=114 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Race (NIH/OMB)
Asian
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Race (NIH/OMB)
White
4 Participants
n=54 Participants
1 Participants
n=60 Participants
5 Participants
n=114 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=114 Participants

PRIMARY outcome

Timeframe: Six months

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the six-month assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidences of all-cause mortality at six (6) months post-surgery.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: One year

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the one-year assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidences of all-cause mortality at (12) months post-surgery.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Six months

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the six-month assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidence of recurrent blood culture positive infection (6 month)

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: One year

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the one-year assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidence of recurrent blood culture positive infection (1 year)

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Six months

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the six-month assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidence of cardiac re-operation (6 Month)

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: One year

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the one-year assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidence of cardiac re-operation (1 Year)

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Six months

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the six-month assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidences of readmission for recurrent infection or cardiac re-operation (6 Month)

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: One year

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to the one-year assessment. As a result, no outcome data were collected for this measure in either arm, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Incidence of readmission for recurrent infection or cardiac re-operation (1 Year)

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Through study completion, an average of one year

Population: All participants enrolled in the study were assigned to a study arm; however, all participants were lost to follow-up prior to study completion. Because no participants completed the study, no cost of care data were collected, and no participants were included in the analysis population. No interim, partial, or alternative data were available for analysis.

Cost of care

Outcome measures

Outcome data not reported

Adverse Events

Group I (Experimental)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Group II (Control Group)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Vinay Badhwar

West Virginia University

Phone: 304-598-4151

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place