Antibiotic Therapy in Viral Airway Infections

Launched by UNIVERSITY HOSPITAL, AKERSHUS · Sep 7, 2021

Keywords

ClinConnect Summary

This clinical trial is studying whether stopping antibiotic treatment early is safe and effective for adults who have respiratory infections caused by viruses, such as influenza or respiratory syncytial virus (RSV). The goal is to see if patients who test positive for these viruses can safely discontinue antibiotics, which are often over-prescribed for infections that don't actually need them. By doing this, the trial aims to help reduce the unnecessary use of antibiotics, which is an important step in fighting antibiotic resistance.

Eligible participants are adults aged 18 and older who are hospitalized for moderately severe respiratory illness and have tested positive for specific viruses. They should currently be receiving antibiotics as prescribed by their doctor. Those with very severe illness or other serious health issues will not be included. If you decide to join the study, you'll receive careful monitoring while assessing whether stopping the antibiotics is a safe choice for your recovery. Your participation could contribute to better treatment practices for respiratory infections in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Hospitalized
• • Adults 18 year or older
• • Moderately severe disease (CRB65 ≤ 2 at time of inclusion)
• • Nasopharyngeal swab positive for influenza virus, parainfluenza virus, respiratory syncytial virus (RSV) or human metapneumovirus (hMPV)
• • On antibiotic therapy as instituted by the receiving physician from the emergency department
• • Signed informed consent must be obtained and documented according to ICH GCP, and national/local regulations.
• Exclusion Criteria:
• • Requiring ICU admission at screening
• • Requiring high-flow oxygen therapy or non-invasive ventilation at screening
• • Signs of severe pneumonia (abscesses, massive pleural effusion, a well-defined lobar infiltrate on chest X-ray strongly suggestive of bacterial etiology)
• • Not immunocompetent (i.e. on active chemotherapy, corticosteroid therapy equaling ≥ 20 mg prednisolone daily for ≥ 4 weeks, chronic immunosuppression due to solid organ transplant)
• • SARS-CoV-2 positive
• • Bacteremia
• • Urine antigen test positive for legionella
• • Any other infection necessitating antibiotic treatment
• • Antibiotic use for assumed airway infection within the last 24 hours before admission to hospital
• • Time from initiation of antibiotic therapy to screening \>48 hours