Impact of Rapid Pathogen Detection in ICU Patients With Suspected Pneumonia on Antimicrobial Therapy

Launched by CHINESE UNIVERSITY OF HONG KONG · Jun 23, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how quickly and accurately detecting respiratory pathogens, which are germs that can cause pneumonia, affects the treatment of critically ill patients who are on mechanical ventilation. Specifically, the trial compares a rapid test called the BioFire FA Pneumonia Panel with standard care to see if it helps doctors choose the right antibiotics faster for patients suspected of having pneumonia. The goal is to improve patient care by making sure they receive the most effective treatment as soon as possible.

To participate, patients must be adults aged 18 and older, currently in the intensive care unit (ICU), and on mechanical ventilation. They should have started new antibiotics within the last 24 hours for suspected pneumonia based on symptoms like cough, fever, or difficulty breathing, along with chest imaging showing signs of infection. However, certain patients, such as those who may not survive the next 48 hours or those with specific medical conditions, are not eligible. Participants will either receive the rapid testing or the usual care, and the study aims to ensure that this method is safe and beneficial for patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • adult (≥18 years old) ICU patients
• • mechanical ventilation
• • new antibiotic prescription within 24 hours for suspected community acquired, healthcare or ventilator associated pneumonia
• • suspected pneumonia is defined as any of purulent sputum, cough, fever, shortness of breath, hypoxia, hypercapnia or abnormal white cell count AND chest infiltrates on imaging
• • need for antibiotics other than suspected respiratory infection
• • aspiration pneumonia
• • suspected pneumonia due to tuberculosis
• • known respiratory pathogens within 7 days prior to randomization
• • given empirical antimicrobials for suspected Stenotrophomonas, Citrobacter infection
• • lack of sufficient respiratory samples for culture and FA Pneumonia Panel
• • not expected to survive beyond 48 hours
• • limitation of therapy prior to recruitment
• • prisoners
• • allergy to antibiotics
• • immunosuppression from long term steroid of at least 5 mg/day or chemotherapy or HIV or haematological disease
• • pregnancy