Trial reportBMJ (Clinical research ed.)2021
Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomised trial.
Trial report in BMJ (Clinical research ed.), 2021. 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 32 papers, 3 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.
Procalcitonin and Lung Ultrasonography Point-of-care Testing to Decide on Antibiotic Prescription in Patients With Lower Respiratory Tract Infection at Primary Care Level: Pragmatic Cluster Randomized Trial
Procalcitonin and Lung Ultrasonography Based Antibiotherapy in Patients With Lower Respiratory Tract Infection in Swiss Emergency Departments: Pragmatic Stepped-wedge Cluster-randomized Trial
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Rapid tests to inform triage and antibiotic prescribing decisions for adults presenting with suspected acute respiratory infection: a rapid evidence synthesis of clinical effectiveness and cost-utility studies.Health technology assessment (Winchester, England) · 2025Pooled it
- 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
- Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Cost-effectiveness analysis of procalcitonin and lung ultrasonography guided antibiotic prescriptions in primary care.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Trial
- Lung ultrasound and procalcitonin, improving antibiotic management and avoiding radiation exposure in pediatric critical patients with bacterial pneumonia: a randomized clinical trial.European journal of medical research · 2024Trial
- Protocol for the ACTIVE trial: a multicentre, open-label, cluster-randomized controlled trial of a quality improvement programme for older adults with hip fracture in resource-limited hospitals in China.Bone & joint open · 2026Article
- Fucose-tobramycin sponge-like microparticles to treat pulmonary Pseudomonas aeruginosa infections in a lectin-competitive approach.Journal of advanced research · 2026Article
- 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
- Dynamic procalcitonin-guided antibiotic stewardship among cancer patients in the UK.Journal of medical microbiology · 2026Article
- Guidelines for the Initial Assessment of Respiratory Distress in the Emergency Department.Annals of intensive care · 2026Article
- Point-of-care ultrasonography in Turkish primary care: a qualitative exploration of practice and experience.BMC primary care · 2025Article
- The effect of focused lung ultrasound on antibiotic prescribing in patients with acute lower respiratory tract infections in Danish general practice (PLUS-FLUS): a pragmatic, randomised controlled, post-market trial.EClinicalMedicine · 2025Article
- The Impact of Point-of-Care Testing for Group A Streptococcal Pharyngitis on Antibiotic Prescribing and Patient Health Outcomes in Outpatient Care: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Open forum infectious diseases · 2025Article
- Evaluating general practitioners' focused lung ultrasound competence and findings in patients with suspected community-acquired pneumonia in general practice.Scandinavian journal of primary health care · 2025Article
- Article
- 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
- Perception of antimicrobial stewardship interventions in Swiss primary care: a mixed-methods survey.BJGP open · 2025Article
- Duration of Antimicrobial Treatment in Adult Patients with Pneumonia: A Narrative Review.Antibiotics (Basel, Switzerland) · 2024Review
- Review: Diagnostic Potential for Collaborative Pharyngitis Biomarkers.The Journal of infectious diseases · 2024Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess whether point-of care procalcitonin and lung ultrasonography can safely reduce unnecessary antibiotic treatment in patients with lower respiratory tract infections in primary care.
designThree group, pragmatic cluster randomised controlled trial from September 2018 to March 2020.
setting60 Swiss general practices.
participantsOne general practitioner per practice was included. General practitioners screen all patients with acute cough; patients with clinical pneumonia were included.
interventionsRandomisation in a 1:1:1 of general practitioners to either antibiotics guided by sequential procalcitonin and lung ultrasonography point-of-care tests (UltraPro; n=152), procalcitonin guided antibiotics (n=195), or usual care (n=122). MAIN OUTCOMES: Primary outcome was proportion of patients in each group prescribed an antibiotic by day 28. Secondary outcomes included duration of restricted activities due to lower respiratory tract infection within 14 days.
results60 general practitioners included 469 patients (median age 53 years (interquartile range 38-66); 278 (59%) were female). Probability of antibiotic prescription at day 28 was lower in the procalcitonin group than in the usual care group (0.40
conclusionsCompared with usual care, point-of-care procalcitonin led to a 26% absolute reduction in the probability of 28 day antibiotic prescription without affecting patients' safety. Point-of-care lung ultrasonography did not further reduce antibiotic prescription, although a potential added value cannot be excluded, owing to the wide confidence intervals.
trial registrationClinicalTrials.gov NCT03191071.
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What OpenQuestion holds
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.