Evidence map›Paper›PMID 35505308›Full record

Trial reportBMC infectious diseases2022

Accuracy of a score predicting the presence of an atypical pathogen in hospitalized patients with moderately severe community-acquired pneumonia.

Aline Chauffard, Pierre-Olivier Bridevaux, Sebastian Carballo, Virginie Prendki, Jean-Luc Reny, Jérôme Stirnemann, Nicolas Garin

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

Trial report in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00818610 (Beta-lactam Monotherapy Versus Beta-lactam - Macrolide Association as Empiric Antibiotherapy Strategies in Non-severe Hospitalized Community-acquired Pneumonia), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 29% 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.

NCT00818610 phase4completednot on this map

Beta-lactam Monotherapy Versus Beta-lactam - Macrolide Association as Empiric Antibiotherapy Strategies in Non-severe Hospitalized Community-acquired Pneumonia: a Randomized, Non-inferiority, Open Trial.

TypeinterventionalSponsorSwiss National Fund for Scientific ResearchRan2009 to 2013Enrolled601ConditionsCommunity-acquired PneumoniaArmsBeta lactam (amoxicillin / clav. acid OR cefuroxime), Beta-lactam (amoxicillin / clav. acid OR cefuroxime) AND macrolide (clarithromycin)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. 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

7 authors at 2 institutions in 1 country.

Aline ChauffardFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Pierre-Olivier BridevauxFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Sebastian CarballoFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Virginie PrendkiFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Jean-Luc RenyFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Jérôme StirnemannFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Nicolas GarinFaculty of Medicine, University of Geneva, Geneva, Switzerland. Nicolas.Garin@hopitalrivierachablais.ch.
University of Geneva · CHUniversity Hospital of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtypical pathogens (AP), present in some patients with community-acquired pneumonia (CAP), are intrinsically resistant to betalactam drugs, the mainstay of empirical antibiotic treatment. Adding antibiotic coverage for AP increases the risk of adverse effects and antimicrobial selection pressure, while withholding such coverage may worsen the prognosis if an AP is causative. A clinical model predicting the presence of AP would allow targeting atypical coverage for patients most likely to benefit.

methodsThis is a secondary analysis of a multicentric randomized controlled trial that included 580 adults patients hospitalized for CAP. A predictive score was built using independent predictive factors for AP identified through multivariate analysis. Accuracy of the score was assessed using area under the receiver operating curve (AUROC), sensitivity, and specificity.

resultsPrevalence of AP was 5.3%. Age < 75 years (OR 2.7, 95% CI 1.2-6.2), heart failure (OR 2.6, 95% CI 1.1-6.1), absence of chest pain (OR 3.0, 95% CI 1.1-8.2), natremia < 135 mmol/L (OR 3.0, 95% CI 1.4-6.6) and contracting the disease in autumn (OR 2.7, 95% CI 1.3-5.9) were independently associated with AP. A predictive score using these factors had an AUROC of 0.78 (95% CI 0.71-0.85). A score of 0 or 1 (present in 33% of patients) had 100% sensitivity and 35% specificity.

conclusionUse of a score built on easily obtained clinical and laboratory data would allow safe withholding of atypical antibiotic coverage in a significant number of patients, with an expected positive impact on bacterial resistance and drug adverse effects.

trial registrationNCT00818610.

Indexed as

Community-Acquired InfectionsPneumoniaAdultAgedAnti-Bacterial AgentsAntibiotic Prophylaxisbeta-LactamsHumansAnti-Bacterial Agentsbeta-LactamsAtypical pathogenCommunity-acquired pneumoniaLegionella pneumophilaMycoplasma pneumoniaePredictive factorPredictive score

Identifiers

PMID35505308
PMCPMC9066797
OpenAlexW4225303567

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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.