Trial reportIntensive care medicine2025
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.
Trial report in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07684300 (Impact of Molecular Microbiology Integrated With Clinical Data on Antimicrobial Therapy Optimization), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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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.
Impact of Molecular Microbiology Integrated With Clinical Data on Antimicrobial Therapy Optimization: An Open-Label Cluster-Randomized Crossover Trial
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Semi-Quantitative Detection of Respiratory Pathogens: A Systematic Review and Meta-Analysis of Results From the BIOFIRE FILMARRAY Pneumonia Panel and Culture.MicrobiologyOpen · 2026Pooled it
- Impact of syndromic molecular diagnostics on antimicrobial adequacy and time to therapy in critically ill patients with pneumonia: a systematic review and meta-analysis of randomized trials.Critical care (London, England) · 2025Pooled it
- Machine says go, doctor says no: an ecological momentary assessment analysis examining clinicians' perceptions of, and their antibiotic prescribing behaviour when using rapid molecular diagnostic tests in intensive care.Antimicrobial resistance and infection control · 2026Trial
- Cost-effectiveness of rapid, ICU-based, syndromic PCR in hospital-acquired pneumonia: analysis of the INHALE WP3 multi-centre RCT.Critical care (London, England) · 2025Trial
- Microbiological profiles of Gram-negative bacteria isolated from respiratory samples of mechanically ventilated patients at a tertiary Moroccan hospital.IJID regions · 2026Article
- Acute Respiratory Distress Syndrome in Hospital-Acquired/Ventilator-Associated Pneumonia.Medical sciences (Basel, Switzerland) · 2026Review
- Impact of a strategy using multiplex PCR on targeted antibiotic therapy for patients with suspected ventilator-associated pneumonia or hospital-acquired pneumonia requiring mechanical ventilation: a randomized, single-blind trial.Intensive care medicine · 2026Article
- PCR-based syndromic tests for antibiotic stewardship in non-ventilated patients with hospital-acquired pneumonia: a multicentre randomized controlled trial.JAC-antimicrobial resistance · 2026Article
- Scenario-Driven Rapid Testing for Top Pathogens in Pediatric Respiratory Infections: Clinical and Economic Value from Emergency Triage to Precision Anti-Infective Management in the PICU.Pathogens (Basel, Switzerland) · 2026Review
- Syndromic Multiplex Polymerase Chain Reaction: The Impact on Microbial Yield in Nonventilator Hospital-Acquired Pneumonia.Open forum infectious diseases · 2026Article
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Rapid testing with molecular syndromic panels of patients presenting at the emergency department with pneumonia at risk for multidrug-resistant pathogens.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Update on infection: from prevention to diagnosis and management.Intensive care medicine · 2026Article
- Application value of Xpert Carba-R combined with LAMP in the diagnosis and prognosis of carbapenem-resistant Gram-negative bacilli pneumonia.Microbiology spectrum · 2026Article
- 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
- Real-world experience using multiplex polymerase chain reaction in intensive care unit patients with hospital-acquired and ventilator-associated pneumonia in South Korea.Acute and critical care · 2026Article
- Severe community-acquired pneumonia: an integral approach.Journal of intensive care · 2026Review
- Observational
- From microscopy to antimicrobial decisions: a clinically grounded roadmap for critical care infectious diseases.Frontiers in artificial intelligence · 2026Review
- Impact of ddPCR panel implementation on optimizing antimicrobial therapy management in critically ill patients with bloodstream infections.Frontiers in cellular and infection microbiology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors.
Funding
Abstract
purposeINHALE investigated the impact of seeking pathogens by PCR on antibiotic stewardship and clinical outcomes in hospital-acquired and ventilator-associated pneumonia (HAP and VAP).
methodsThis pragmatic multicentre, open-label RCT enrolled adults and children with suspected HAP and VAP at 14 ICUs. Patients were randomly allocated to standard of care, or rapid in-ICU syndromic PCR coupled with optional prescribing guidance. Co-primary outcomes were superiority in antibiotic stewardship at 24 h and non-inferiority in clinical cure of pneumonia 14 days post-randomisation. Secondary outcomes included mortality, ICU length of stay and evolution of clinical scores.
results554 eligible patients were recruited from 5th July 2019 to 18th August 2021, with a COVID-enforced pause from 16th March 2020 and 9th July 2020. Data were analysed for 453 adults and 92 children (68.4% male; 31.6% female). ITT analysis showed 205/268 (76.5%) reviewable intervention patients receiving antibacterially appropriate and proportionate antibiotics at 24 h, versus 147/263 (55.9%) standard-of-care patients (estimated difference 21%; 95% CI 13-28%). However, only 152/268 (56.7%) intervention patients were deemed cured of pneumonia at 14 days, versus 171/265 (64.5%) standard-of-care patients (estimated difference - 6%, 95% CI - 15 to 2%; predefined non-inferiority margin -13%). Secondary mortality and ΔSOFA outcomes narrowly favoured the control arm, without clear statistical significance.
conclusionsIn-ICU PCR for pathogens resulted in improved antibiotic stewardship. However, non-inferiority was not demonstrated for cure of pneumonia at 14 days. Further research should focus on clinical effectiveness studies to elucidate whether antibiotic stewardship gains achieved by rapid PCR can be safely and advantageously implemented.
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