Evidence map›Paper›PMID 28426811›Full record

Trial reportPloS one2017

Procalcitonin for selecting the antibiotic regimen in outpatients with low-risk community-acquired pneumonia using a rapid point-of-care testing: A single-arm clinical trial.

Mar Masiá, Sergio Padilla, Victoria Ortiz de la Tabla, Matilde González, Cristina Bas, Félix Gutiérrez

Registry-linked trialOpen access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02600806 (Evaluation of a Clinical Pathway Based on Procalcitonin Levels for the Management of Community-acquired Pneumonia in Outpatients), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02600806 phase4unknown statusnot on this map

Evaluation of a Clinical Pathway Based on Procalcitonin Levels for the Management of Community-acquired Pneumonia in Outpatients

TypeinterventionalSponsorFundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat ValencianaRan2005 to 2016Enrolled500ConditionsCommunity-acquired PneumoniaArmsAzithromycin, Levofloxacin
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Evaluation of the VircliaJournal of clinical laboratory analysis · 2018
    Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Mar MasiáInfectious Diseases Unit, Hospital General Universitario de Elche, Universidad Miguel Hernández, Alicante, Spain.
Sergio PadillaInfectious Diseases Unit, Hospital General Universitario de Elche, Universidad Miguel Hernández, Alicante, Spain.
Victoria Ortiz de la TablaMicrobiology Service, Hospital Universitario de San Juan, Alicante, Spain.
Matilde GonzálezEmergency Department, Hospital General Universitario de Elche, Elche, Spain.
Cristina BasInfectious Diseases Unit, Hospital General Universitario de Elche, Universidad Miguel Hernández, Alicante, Spain.
Félix GutiérrezInfectious Diseases Unit, Hospital General Universitario de Elche, Universidad Miguel Hernández, Alicante, Spain.
Universitat de Miguel Hernández d'Elx · ESHospital General Universitario de Elche · ESHospital Universitari Sant Joan D'Alacant · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe aimed to assess the role of procalcitonin (PCT) to guide the initial selection of the antibiotic regimen for low-risk community-acquired pneumonia (CAP).

methodsA single-arm clinical trial was conducted including outpatients with CAP and Pneumonia Severity Index risk classes I-II. Antimicrobial selection was based on the results of PCT measured with a rapid point-of-care testing. According to serum PCT levels, patients were assigned to two treatment strategies: oral azithromycin if PCT was <0.5 ng/ml, or levofloxacin if levels were ≥0.5 ng/ml. Primary outcome was clinical cure rate. Short-term and long-term outcomes were assessed. Results were compared with those of a historical standard-of-care control-group treated in our centre.

resultsOf 253 subjects included, 216 (85.4%) were assigned to azithromycin. Pneumococcal infection was diagnosed in 26 (12%) and 21 (56.8%) patients allocated to azithromycin and levofloxacin groups, respectively. No patients in the azithromycin group developed bacteraemia. Atypical organisms were more common in patients given azithromycin (18.5% vs 8.1%, respectively). The majority (93%) of patients with atypical pneumonia had low PCT levels. Clinical cure rates were 95.8% in the azithromycin group, 94.6% in the levofloxacin group, and 94.4% in the historical control group. No 30-day mortality or recurrences were observed, and the 3-year rates of recurrence and mortality were very low in both groups. Adverse events occurrence was also infrequent.

conclusionA PCT-guided strategy with a rapid point-of-care testing safely allowed selecting empirical narrow-spectrum antibiotics in outpatients with CAP.

trial registrationThe study is registered with ClinicalTrials.gov, number NCT02600806.

Indexed as

OutpatientsPoint-of-Care SystemsAdultAnti-Bacterial AgentsCalcitoninCommunity-Acquired InfectionsFemaleHumansMaleMiddle AgedPneumoniaAnti-Bacterial AgentsCalcitonin

Identifiers

PMID28426811
PMCPMC5398537
OpenAlexW2606630446

What OpenQuestion holds

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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.