Trial reportClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2023
Respiratory multiplex PCR and procalcitonin to reduce antibiotic exposure in severe SARS-CoV-2 pneumonia: a multicentre randomized controlled trial.
Trial report in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Pooled it
- Guideline
- [Ten key statements of the S3 guideline "Epidemiology, diagnosis, and treatment of adult patients with nosocomial pneumonia"].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Guideline
- INHALE WP3, a multicentre, open-label, pragmatic randomised controlled trial assessing the impact of rapid, ICU-based, syndromic PCR, versus standard-of-care on antibiotic stewardship and clinical outcomes in hospital-acquired and ventilator-associated pneumonia.Intensive care medicine · 2025Trial
- Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis.EClinicalMedicine · 2026Article
- Molecular diagnostic technology: beyond analytical accuracy.Critical care (London, England) · 2025Article
- Diagnostic performance of Pneumonia multiplex PCR in critically ill immunocompromised patients.Critical care (London, England) · 2025Article
- PCR and biomarker algorithms to guide antibiotics in lower respiratory tract infections-is the future now?The Lancet regional health. Europe · 2025Article
- Model-based cost-impact analysis of a diagnostic test for patients with community-acquired pneumonia in Canada.BMC infectious diseases · 2025Article
- Early Predictive Value of Infectious Markers for Ventilator-associated Pneumonia after Stanford Type A Aortic Dissection Surgery.Reviews in cardiovascular medicine · 2025Article
- Diagnostic Performance and Impact on Antimicrobial Treatment of a Multiplex Polymerase Chain Reaction in Critically Ill Patients With Pneumonia: A Multicenter Observational Study (The MORICUP-PCR Study: Morocco ICU Pneumonia-PCR study).Critical care explorations · 2025Observational
- 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
- Rapid Molecular Diagnostics of Pneumonia Caused by Gram-Negative Bacteria: A Clinician's Review.Antibiotics (Basel, Switzerland) · 2024Review
- Performance and impact of rapid multiplex PCR on diagnosis and treatment of ventilated hospital-acquired pneumonia in patients with extended-spectrum β-lactamase-producing Enterobacterales rectal carriage.Annals of intensive care · 2024Article
- The Evolving Challenge of Appropriate Antibiotics Use in Hospitalized COVID-19 Patients: A Systematic Literature Review.Antibiotics (Basel, Switzerland) · 2024Review
- Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia.Antibiotics (Basel, Switzerland) · 2024Review
- Are C-reactive protein and procalcitonin safe and useful for antimicrobial stewardship purposes in patients with COVID-19? A scoping review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Performance and Impact on Antibiotic Prescriptions of a Multiplex PCR in a Real-Life Cohort of Critically Ill Patients with Suspected Ventilated Pneumonia: A Retrospective Monocentric Observational Study.Antibiotics (Basel, Switzerland) · 2023Article
- ICU-Acquired Colonization and Infection Related to Multidrug-Resistant Bacteria in COVID-19 Patients: A Narrative Review.Antibiotics (Basel, Switzerland) · 2023Review
- An Observational Study to Develop a Predictive Model for Bacterial Pneumonia Diagnosis in Severe COVID-19 Patients-C19-PNEUMOSCORE.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
18 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aimed at assessing the efficacy and safety on antibiotic exposure of a strategy combining a respiratory multiplex PCR (mPCR) with enlarged panel and daily procalcitonin (PCT) measurements, as compared with a conventional strategy, in adult patients who were critically ill with laboratory-confirmed SARS-CoV-2 pneumonia.
methodsThis multicentre, parallel-group, open-label, randomized controlled trial enrolled patients admitted to 13 intensive care units (ICUs) in France. Patients were assigned (1:1) to the control strategy, in which antibiotic streamlining remained at the discretion of the physicians, or interventional strategy, consisting of using mPCR and daily PCT measurements within the first 7 days of randomization to streamline initial antibiotic therapy, with antibiotic continuation encouraged when PCT was >1 ng/mL and discouraged if < 1 ng/mL or decreased by 80% from baseline. All patients underwent conventional microbiological tests and cultures. The primary end point was antibiotic-free days at day 28.
resultsBetween April 20th and November 23rd 2020, 194 patients were randomized, of whom 191 were retained in the intention-to-treat analysis. Respiratory bacterial co-infection was detected in 48.4% (45/93) and 21.4% (21/98) in the interventional and control group, respectively. The number of antibiotic-free days was 12.0 (0.0; 25.0) and 14.0 (0.0; 24.0) days, respectively (difference, -2.0, (95% CI, -10.6 to 6.6), p=0.89). Superinfection rates were high (51.6% and 48.5%, respectively). Mortality rates and ICU lengths of stay did not differ between groups. DISCUSSION: In severe SARS-CoV-2 pneumonia, the mPCR/PCT algorithm strategy did not affect 28-day antibiotics exposure nor the major clinical outcomes, as compared with routine practice.
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