Evidence map›Paper›PMID 35279069›Full record

ArticleBMC primary care2022

The Procalcitonin-guided Antibiotics in Respiratory Infections (PARI) project in general practice - a study protocol.

Nadia Filipsen, Holger Bro, Lars Bjerrum, Jens-Ulrik Staehr Jensen, Rune Aabenhus

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04216277 (The Procalcitonin Guided Antibiotics in Respiratory Infections in General Practice), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 38% 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.

NCT04216277 nawithdrawnnot on this map

The Procalcitonin Guided Antibiotics in Respiratory Infections in General Practice

TypeinterventionalSponsorChronic Obstructive Pulmonary Disease Trial Network, DenmarkRan2020 to 2022Enrolled0ConditionsAcute Respiratory Tract InfectionArmsProcalcitonin
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Selection and reporting of usual care comparators when designing primary care trials of complex health interventions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
  2. Article
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

5 authors at 3 institutions in 1 country.

Nadia FilipsenDepartment of Public Health, Section of General Practice, University of Copenhagen, Copenhagen, Denmark. nadia.filipsen@sund.ku.dk.ORCID 0000-0002-8688-4956
Holger BroGeneral Practice, Naestved Laegecenter, Naestved, Denmark.
Lars BjerrumDepartment of Public Health, Section of General Practice, University of Copenhagen, Copenhagen, Denmark.
Jens-Ulrik Staehr JensenDepartment of Internal Medicine, Herlev and Gentofte University Hospital, Copenhagen, Denmark.
Rune AabenhusDepartment of Public Health, Section of General Practice, University of Copenhagen, Copenhagen, Denmark.
University of Copenhagen · DKGentofte Hospital · DKNæstved Sygehus · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotic resistance is a global health challenge and the close correlation between antibiotic use and the development of resistance makes it essential to maintain a rational use of antibiotics. Most antibiotics are prescribed in general practice against acute respiratory tract infections (ARTI), even though most of these infections are of viral etiology. Thus, a safe method to substantially reduce unnecessary use of antibiotics in general practice is needed. Procalcitonin (PCT) is a precursor protein with very low circulating levels in the blood under physiological conditions. However, in response serious bacterial infection the level of PCT in the blood may increase significantly. Until recently, quantitative analyses of PCT was performed in hospital laboratories, impeding the implementation of PCT in primary care. Our aim is to determine whether it is possible to lower the use of antibiotics in patients presenting with symptoms of ARTI, without significantly prolonging the period of illness, by using a newly released PCT point-of-care test in general practice.

methodsThe Procalcitonin-Guided Antibiotics in Respiratory Infections (PARI) study is a randomized, single-blinded, non-inferiority, multi-practice intervention study comparing a PCT-group to a control group. Patients (N = 508) will be randomly assigned 1:1 to standard care or to the PCT group. The primary outcomes the duration of illness and symptoms from ARTI measured with the Acute Respiratory Tract Infection Questionnaire. Secondary outcomes include (1) Number of participants in each trial arm exposed to antibiotic treatment at index consultation (day 1) and within 30 days, (2) Number of participants in each trial arm with side effects from antibiotic treatment within 14 days, (3) Number of participants in each trial arm with re-consultations within 30 days, (4) Number of participants in each trial arm admitted to hospital (including diagnosis and mortality) within 30 days, (5) Characterization of biomarker (CRP and PCT) level at index consultation. Tertiary outcomes include patient and general practitioner satisfaction with the use of the PCT point-of-care test, and long-term follow-up. DISCUSSION: To our knowledge, this is the first study to examine a PCT point-of-care test in general practice with the aim of reducing the use of antibiotics in patients with symptoms of ARTI. Results of this study may prove important in targeting antibiotic treatment only to those patients who need it, thus contributing to limiting the spread of antibiotic resistance.

trial registrationClinicalTrials.gov Identifier: NCT04216277 , date of registration: 2. of January 2020.

Indexed as

Bacterial InfectionsGeneral PracticeRespiratory Tract InfectionsAnti-Bacterial AgentsEquivalence Trials as TopicHumansProcalcitoninRandomized Controlled Trials as TopicAnti-Bacterial AgentsProcalcitoninAcute respiratory tract infectionAntibiotic useGeneral practicePoint-of-care testProcalcitonin

Identifiers

PMID35279069
PMCPMC8917812
OpenAlexW4220664879

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.