Trial reportPloS one2013
Procalcitonin guidance to reduce antibiotic treatment of lower respiratory tract infection in children and adolescents (ProPAED): a randomized controlled trial.
Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 113 citations in OpenAlex.
- Procalcitonin-guided antibiotic therapy for pediatrics with infective disease: A updated meta-analyses and trial sequential analysis.Frontiers in cellular and infection microbiology · 2022Pooled it
- Efficacy and safety of azithromycin versus placebo to treat lower respiratory tract infections associated with low procalcitonin: a randomised, placebo-controlled, double-blind, non-inferiority trial.The Lancet. Infectious diseases · 2023Trial
- The kinetic profiles of copeptin and mid regional proadrenomedullin (MR-proADM) in pediatric lower respiratory tract infections.PloS one · 2022Trial
- Trial
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- The Role and Importance of Procalcitonin (PCT) Testing in Rational Antibiotic Prescribing and Antibiotic Stewardship Programs.Immunity, inflammation and disease · 2026Review
- A Practical Guide to the Roles of Procalcitonin Measurement in Patients with Acute Pancreatitis.Journal of clinical medicine · 2026Review
- Diagnostic testing and antibiotic stewardship for pneumonia in children worldwide: current developments and next steps.Current opinion in pediatrics · 2025Review
- Recent Advances in Pediatric Infectious Diseases: A Review of Diagnostic and Therapeutic Strategies.Cureus · 2025Review
- The impact of procalcitonin-guided antibiotic treatment on treatment duration and hospital costs in children-balancing benefits and burdens.Translational pediatrics · 2025Article
- Use of procalcitonin in therapeutic decisions in the pediatric intensive care unit.Annals of intensive care · 2025Review
- Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- De-implementation strategy to reduce unnecessary antibiotic prescriptions for ambulatory HIV-infected patients with upper respiratory tract infections in Mozambique: a study protocol of a cluster randomized controlled trial.Implementation science : IS · 2024Article
- Evaluation of serological assays for the diagnosis of childhood tuberculosis disease: a study protocol.BMC infectious diseases · 2024Article
- Antimicrobial Stewardship in Pediatric Emergency Medicine: A Narrative Exploration of Antibiotic Overprescribing, Stewardship Interventions, and Performance Metrics.Children (Basel, Switzerland) · 2024Review
- Procalcitonin Guided Antibiotic Stewardship.Biomarker insights · 2024Review
- Management of Pediatric Pneumonia: A Decade After the Pediatric Infectious Diseases Society and Infectious Diseases Society of America Guideline.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Variation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections.Journal of hospital medicine · 2022Article
- Low Levels of Procalcitonin Are Related to Decreased Antibiotic Use in Children Hospitalized Due to Influenza.Diagnostics (Basel, Switzerland) · 2022Article
- Role of procalcitonin in diagnosis of community acquired pneumonia in Children.BMC pediatrics · 2022Article
Corrections and comments
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Authors and funding
18 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotics are overused in children and adolescents with lower respiratory tract infection (LRTI). Serum-procalcitonin (PCT) can be used to guide treatment when bacterial infection is suspected. Its role in pediatric LRTI is unclear.
methodsBetween 01/2009 and 02/2010 we randomized previously healthy patients 1 month to 18 years old presenting with LRTI to the emergency departments of two pediatric hospitals in Switzerland to receive antibiotics either according to a PCT guidance algorithm established for adult LRTI or standard care clinical guidelines. In intention-to-treat analyses, antibiotic prescribing rate, duration of antibiotic treatment, and number of days with impairment of daily activities within 14 days of randomization were compared between the two groups.
resultsIn total 337 children, mean age 3.8 years (range 0.1-18), were included. Antibiotic prescribing rates were not significantly different in PCT guided patients compared to controls (OR 1.26; 95% CI 0.81, 1.95). Mean duration of antibiotic exposure was reduced from 6.3 to 4.5 days under PCT guidance (-1.8 days; 95% CI -3.1, -0.5; P = 0.039) for all LRTI and from 9.1 to 5.7 days for pneumonia (-3.4 days 95% CI -4.9, -1.7; P<0.001). There was no apparent difference in impairment of daily activities between PCT guided and control patients.
conclusionPCT guidance reduced antibiotic exposure by reducing the duration of antibiotic treatment, while not affecting the antibiotic prescribing rate. The latter may be explained by the low baseline prescribing rate in Switzerland for pediatric LRTI and the choice of an inappropriately low PCT cut-off level for this population.
trial registrationControlled-Trials.com ISRCTN17057980 http://www.controlled-trials.com/ISRCTN17057980.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.