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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT02173613
Other study ID # 1120
Secondary ID
Status Terminated
Phase N/A
First received
Last updated
Start date August 2012
Est. completion date March 2016

Study information

Verified date February 2016
Source University Hospital, Grenoble
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The main objective is to evaluate the interest of the repeated measurement of procalcitonin in patients with pulmonary infection to reduce the duration of antibiotic therapy in comparison with a conventional clinical strategy.


Recruitment information / eligibility

Status Terminated
Enrollment 117
Est. completion date March 2016
Est. primary completion date December 2015
Accepts healthy volunteers No
Gender All
Age group 80 Years and older
Eligibility Inclusion Criteria: - Age = 80 years - Started antibiotics for a chest infection - Procalcitonin performed J0 antibiotic treatment - Person affiliated to the social security Exclusion Criteria: - Patients with a documented infection with germs after Listeria spp, Legionella pneumophilia, Mycobacterium tuberculosis - Patients with a documented infection with a virus or parasite (eg hemorrhagic fever, malaria) - Patients with endovascular infection associated (endocarditis, pacemaker. Intravascular catheter) - Patients with lung abscess associated upon entry Patients with a chronic infection associated - Patients with severe immunosuppression (HIV or transplant) - Palliative patient - Death within 24 hours of admission to nursing units. - Presence of antibiotic treatment for chronic infection. - Patient under guardianship, curatorship or any other administrative or judicial action or deprivation of the right or freedom - Patients hospitalized without their consent

Study Design


Related Conditions & MeSH terms


Intervention

Other:
procalcitonine
The recommendations will be based on the level of PCT: 4 levels of advice will be given: It is highly recommended to stop antibiotics if PCT <0.1ng/ml, and the recommended stop if 0.1ng/ml <PCT <0.25 ng / ml. It is recommended to continue treatment if 0.25 ng / ml <PCT ng / ml. Finally, if the initial PCT greater than 10 ng / ml, a stop will be advised in case of reduction to less than 10% of baseline level.

Locations

Country Name City State
France University Hospital Grenoble Grenoble Rhone Alpes

Sponsors (1)

Lead Sponsor Collaborator
University Hospital, Grenoble

Country where clinical trial is conducted

France, 

References & Publications (45)

Agarwal G, Awasthi S, Kabra SK, Kaul A, Singhi S, Walter SD; ISCAP Study Group. Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial. BMJ. 2004 Apr 3;328(7443):791. Epub 2004 Mar 16. Erratum in: BMJ. 2004 May 1;328(7447):1066. — View Citation

Bignardi GE, Dhar R, Heycock R, Bansal S, Majmudar N. Can procalcitonin testing reduce antibiotic prescribing for respiratory infections? Age Ageing. 2006 Nov;35(6):625-6. Epub 2006 Jul 5. — View Citation

Bonomo RA. Multiple antibiotic-resistant bacteria in long-term-care facilities: An emerging problem in the practice of infectious diseases. Clin Infect Dis. 2000 Dec;31(6):1414-22. Epub 2000 Nov 29. Review. — View Citation

Briel M, Schuetz P, Mueller B, Young J, Schild U, Nusbaumer C, Périat P, Bucher HC, Christ-Crain M. Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care. Arch Intern Med. 2008 Oct 13;168(18):2000-7; discussion 2007-8. doi: 10.1001/archinte.168.18.2000. — View Citation

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Caterino JM, Scheatzle MD, Forbes ML, D'Antonio JA. Bacteremic elder emergency department patients: procalcitonin and white count. Acad Emerg Med. 2004 Apr;11(4):393-6. — View Citation

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Chirouze C, Schuhmacher H, Rabaud C, Gil H, Khayat N, Estavoyer JM, May T, Hoen B. Low serum procalcitonin level accurately predicts the absence of bacteremia in adult patients with acute fever. Clin Infect Dis. 2002 Jul 15;35(2):156-61. Epub 2002 Jun 17. — View Citation

Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, Müller B. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004 Feb 21;363(9409):600-7. — View Citation

Christ-Crain M, Müller B. Biomarkers in respiratory tract infections: diagnostic guides to antibiotic prescription, prognostic markers and mediators. Eur Respir J. 2007 Sep;30(3):556-73. Review. — View Citation

Christ-Crain M, Stolz D, Bingisser R, Müller C, Miedinger D, Huber PR, Zimmerli W, Harbarth S, Tamm M, Müller B. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med. 2006 Jul 1;174(1):84-93. Epub 2006 Apr 7. — View Citation

Dwolatzky T, Olshtain-Pops K, Yinnon AM, Raveh D, Rogowski O, Shapira I, Rotstein R, Berliner S, Rudensky B. Procalcitonin in the elderly: normal plasma concentrations and response to bacterial infections. Eur J Clin Microbiol Infect Dis. 2005 Nov;24(11):763-5. — View Citation

el Moussaoui R, de Borgie CA, van den Broek P, Hustinx WN, Bresser P, van den Berk GE, Poley JW, van den Berg B, Krouwels FH, Bonten MJ, Weenink C, Bossuyt PM, Speelman P, Opmeer BC, Prins JM. Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study. BMJ. 2006 Jun 10;332(7554):1355. — View Citation

El Solh AA, Aquilina AT, Gunen H, Ramadan F. Radiographic resolution of community-acquired bacterial pneumonia in the elderly. J Am Geriatr Soc. 2004 Feb;52(2):224-9. — View Citation

Fein AM. Pneumonia in the elderly: overview of diagnostic and therapeutic approaches. Clin Infect Dis. 1999 Apr;28(4):726-9. Review. — View Citation

Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, Coley CM, Marrie TJ, Kapoor WN. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997 Jan 23;336(4):243-50. — View Citation

Fischer JE, Harbarth S, Agthe AG, Benn A, Ringer SA, Goldmann DA, Fanconi S. Quantifying uncertainty: physicians' estimates of infection in critically ill neonates and children. Clin Infect Dis. 2004 May 15;38(10):1383-90. Epub 2004 Apr 29. — View Citation

Galetto-Lacour A, Zamora SA, Gervaix A. Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center. Pediatrics. 2003 Nov;112(5):1054-60. — View Citation

Gaymu J. Aspects démographiques du vieillissement; Bulletin Epidémiologique Hebdomadaire. 2006; 5-6:38-9.

Gendrel D, Raymond J, Coste J, Moulin F, Lorrot M, Guérin S, Ravilly S, Lefèvre H, Royer C, Lacombe C, Palmer P, Bohuon C. Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections. Pediatr Infect Dis J. 1999 Oct;18(10):875-81. — View Citation

Gervaix A, Galetto-Lacour A, Gueron T, Vadas L, Zamora S, Suter S, Girardin E. Usefulness of procalcitonin and C-reactive protein rapid tests for the management of children with urinary tract infection. Pediatr Infect Dis J. 2001 May;20(5):507-11. — View Citation

Gervaix A, Pugin J. [Usefulness of procalcitonin in adults and children]. Rev Med Suisse. 2005 Mar 30;1(13):872-4, 877. Review. French. — View Citation

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Harbarth S, Holeckova K, Froidevaux C, Pittet D, Ricou B, Grau GE, Vadas L, Pugin J; Geneva Sepsis Network. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med. 2001 Aug 1;164(3):396-402. — View Citation

Harbarth S. Nosocomial transmission of antibiotic-resistant microorganisms. Curr Opin Infect Dis. 2001 Aug;14(4):437-42. Review. — View Citation

High KP. Infection as a cause of age-related morbidity and mortality. Ageing Res Rev. 2004 Jan;3(1):1-14. Review. — View Citation

Hochreiter M, Köhler T, Schweiger AM, Keck FS, Bein B, von Spiegel T, Schroeder S. Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial. Crit Care. 2009;13(3):R83. doi: 10.1186/cc7903. Epub 2009 Jun 3. — View Citation

KATZ S, FORD AB, MOSKOWITZ RW, JACKSON BA, JAFFE MW. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963 Sep 21;185:914-9. — View Citation

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Kristoffersen KB, Søgaard OS, Wejse C, Black FT, Greve T, Tarp B, Storgaard M, Sodemann M. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission--a randomized trial. Clin Microbiol Infect. 2009 May;15(5):481-7. doi: 10.1111/j.1469-0691.2009.02709.x. Epub 2009 Mar 5. — View Citation

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Nobre V, Harbarth S, Graf JD, Rohner P, Pugin J. Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial. Am J Respir Crit Care Med. 2008 Mar 1;177(5):498-505. Epub 2007 Dec 20. — View Citation

Polton D, Sermet C. Le vieillissement de la population va-t-il submerger le système de santé ? Bulletin Epidémiologique Hebdomadaire. 2006; 5-6:49-52.

Rooney PJ, O'Leary MC, Loughrey AC, McCalmont M, Smyth B, Donaghy P, Badri M, Woodford N, Karisik E, Livermore DM. Nursing homes as a reservoir of extended-spectrum beta-lactamase (ESBL)-producing ciprofloxacin-resistant Escherichia coli. J Antimicrob Chemother. 2009 Sep;64(3):635-41. doi: 10.1093/jac/dkp220. Epub 2009 Jun 23. — View Citation

Schuetz P, Christ-Crain M, Wolbers M, Schild U, Thomann R, Falconnier C, Widmer I, Neidert S, Blum CA, Schönenberger R, Henzen C, Bregenzer T, Hoess C, Krause M, Bucher HC, Zimmerli W, Müller B; ProHOSP study group. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial. BMC Health Serv Res. 2007 Jul 5;7:102. — View Citation

Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004 Jul 15;39(2):206-17. Epub 2004 Jul 2. Review. Erratum in: Clin Infect Dis. 2005 May 1;40(9):1386-8. — View Citation

Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):505-11. — View Citation

Stolz D, Christ-Crain M, Bingisser R, Leuppi J, Miedinger D, Müller C, Huber P, Müller B, Tamm M. Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest. 2007 Jan;131(1):9-19. — View Citation

Stucker F, Herrmann F, Graf JD, Michel JP, Krause KH, Gavazzi G. Procalcitonin and infection in elderly patients. J Am Geriatr Soc. 2005 Aug;53(8):1392-5. — View Citation

Tang H, Huang T, Jing J, Shen H, Cui W. Effect of procalcitonin-guided treatment in patients with infections: a systematic review and meta-analysis. Infection. 2009 Dec;37(6):497-507. doi: 10.1007/s15010-009-9034-2. Epub 2009 Oct 13. Review. — View Citation

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* Note: There are 45 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Duration of antibiotic therapy Success of antibiotic therapy within 45 days of inclusion
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