Inhalation Pneumonia Clinical Trial
There is actually no consensus in place defining for which patients with suspected inhalation
pneumonia antibiotic treatment should be initiated and what the duration of this antibiotic
treatment should be.
This absence of recommendations results in excessive use of antibiotics, in emergence of
multi-resistant strains and increase of costs. Several studies have been performed
investigating antibiotic treatment based on procalcitonin values and have demonstrated a
decreased use of antibiotics without change in mortality rates, in duration of
hospitalization, in occurrence of super-infections or in infection relapse rate. Of the
studies performed in an intensive care setting, none has specifically studied inhalation
pneumonia.
The objective of this study is to determine whether use of a decisional algorithm based on
procalcitonin values allows reducing antibiotics exposure in patients who are intubated
because of coma in comparison with standard care according to actual guidelines and clinical
experience with respect to ventilator-acquired pneumonia.
The study has a prospective, multi-centre, comparative, randomized, open design. It is a
superiority study, with as primary parameter the duration of antibiotic therapy during the
first 15 days after admission in the intensive care unit (ICU).
Patients can be included in this study if they are intubated for coma (Glasgow Coma Scale
(GCS) ≤ 8) within 48 hours following admission to the hospital and with a foreseen duration
of ventilation exceeding 48 hours.
There will be two treatment groups, stratified by centre and randomised in blocs of 4: one
group for which treatment initiation and discontinuation will be guided by a
procalcitonin-based decisional algorithm and a control group to whom antibiotics will be
administered according to the standard protocols of each participating centre.
Based on an estimated duration of antibiotic treatment of 6.2 days, a risk -significance α
level- of 5%, a power of 90% and a reduction of antibiotic treatment duration of 25% in the
treatment arm guided by procalcitonin values, the number of patients to be included is 83 per
treatment arm. Taking into account a loss of 10% for patients lost to follow-up, 166 patients
should be included.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
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| Recruiting |
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