Trial reportThe Journal of infectious diseases2015
Serum Procalcitonin Measurement and Viral Testing to Guide Antibiotic Use for Respiratory Infections in Hospitalized Adults: A Randomized Controlled Trial.
Trial report in The Journal of infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 68 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Viral Testing and Biomarkers to Reduce Antibiotic Use for Respiratory Infections
PROARRAY : Impact on PCT+ FilmArray RP2 Plus Use in LRTI Suspicion in Emergency Department
Who cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Procalcitonin-guided antibiotic therapy may shorten length of treatment and may improve survival-a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Nucleic Acid-based Testing for Noninfluenza Viral Pathogens in Adults with Suspected Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2021Guideline
- Rapid Molecular Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review of Diagnostic Accuracy and Clinical Impact Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.The Cochrane database of systematic reviews · 2017Pooled it
- Trial
- Clinical impact of a routine, molecular, point-of-care, test-and-treat strategy for influenza in adults admitted to hospital (FluPOC): a multicentre, open-label, randomised controlled trial.The Lancet. Respiratory medicine · 2021Trial
- Impact of multiplex respiratory virus testing on antimicrobial consumption in adults in acute care: a randomized clinical trial.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2020Trial
- Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: a randomized clinical trial.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2019Trial
- Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection.The New England journal of medicine · 2018Trial
- Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomised controlled trial.The Lancet. Respiratory medicine · 2017Trial
- 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
- Procalcitonin in the management of lower respiratory tract infection and sepsis.The Journal of antimicrobial chemotherapy · 2026Article
- Guidelines for the Initial Assessment of Respiratory Distress in the Emergency Department.Annals of intensive care · 2026Article
- The use and misuse of procalcitonin in the management of pneumonia: a retrospective analysis at a large tertiary care center.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Diagnostic yield of viral multiplex PCR during acute exacerbation of COPD admitted to the intensive care unit: a pilot study.Scientific reports · 2024Observational
- Procalcitonin Guided Antibiotic Stewardship.Biomarker insights · 2024Review
- Acute kidney injury in critical care: complications of hemophagocytic lymphohistiocytosis.Frontiers in immunology · 2024Review
- Rapid diagnostics to enhance therapy selection for the treatment of bacterial infections.Current pharmacology reports · 2023Article
- Leveraging diagnostic stewardship within antimicrobial stewardship programmes.Drugs in context · 2023Review
8 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundViral lower respiratory tract illness (LRTI) frequently causes adult hospitalization and is linked to antibiotic overuse. European studies suggest that the serum procalcitonin (PCT) level may be used to guide antibiotic therapy. We conducted a trial assessing the feasibility of using PCT algorithms with viral testing to guide antibiotic use in a US hospital.
methodsThree hundred patients hospitalized with nonpneumonic LRTI during October 2013-April 2014 were randomly assigned at a ratio of 1:1 to receive standard care or PCT-guided care and viral PCR testing. The primary outcome was antibiotic exposure, and safety was assessed at 1 and 3 months.
resultsAmong the 151 patients in the intervention group, viruses were identified in 42% (63), and 83% (126) had PCT values of <0.25 µg/mL. There were no significant differences in antibiotic use or adverse events between intervention patients and those in the nonintervention group. Subgroup analyses revealed fewer subjects with positive results of viral testing and low PCT values who were discharged receiving antibiotics (20% vs 45%; P = .002) and shorter antibiotic durations among algorithm-adherent intervention patients versus nonintervention patients (2.0 vs 4.0 days; P = .004). Compared with historical controls (from 2008-2011), antibiotic duration in nonintervention patients decreased by 2 days (6.0 vs 4.0 days; P < .001), suggesting a study effect.
conclusionsAlthough antibiotic use was similar in the 2 arms, subgroup analyses of intervention patients suggest that physicians responded to viral and biomarker data. These data can inform the design of future US studies. CLINICAL TRIALS REGISTRATION: NCT01907659.
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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.