Early Discontinuation of Antibiotic Therapy in Elderly Patients Hospitalized for a Viral Infection

Launched by CENTRE HOSPITALIER UNIVERSITAIRE, AMIENS · Jun 12, 2025

Keywords

ClinConnect Summary

This clinical trial is looking at whether stopping antibiotics early is safe and helpful for elderly patients hospitalized with serious viral lung infections, like the flu or RSV. These viruses can be very dangerous, especially for older adults, and sometimes doctors give antibiotics because they worry about a bacterial infection happening at the same time. However, bacterial infections are actually rare, and unnecessary use of antibiotics can cause harm. This study aims to provide clear evidence on whether antibiotics are truly needed in these cases, or if stopping them early is better for patients.

To take part, patients must be 65 years or older and hospitalized with signs of a lung infection, such as fever, changes in blood counts, or abnormal lung sounds, confirmed by a chest scan or X-ray. They also need to have had a test to identify the virus or bacteria within 48 hours of hospital admission. People who are very severely ill, expected to be in the hospital less than two days, or have other serious bacterial infections won’t be included. Participants will be closely monitored to see if stopping antibiotics early affects their recovery. This study could help improve how antibiotics are used in older adults with viral infections, reducing unnecessary treatment and its side effects.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients ≥ 65 years affiliated to a social security scheme
• * Hospitalized for a lower respiratory infection defined as:
• * the presence of 2 of the following 4 signs:
• • hyperthermia \>38°C,
• • hyperleukocytosis ≥12000 or ≤4000,
• • purulent aspirations/sputum,
• • rales on pulmonary auscultation indicating parenchymal damage
• • associated with a pulmonary image (standard X-ray, CT scan or ultrasound)
• • Microbiological diagnostic sample taken within 48 hours
• • Informed consent of the patient or their representative
• Exclusion Criteria:
• • Hospitalization planned for \< 48 hours or transfer planned to another center within 7 days
• • Patient in septic shock,
• • Febrile aplasia
• • Absence of diagnostic microbiological sampling (\> 48 hours after admission)
• • Moribund patient,
• • Death expected within the week
• • Inhalation proven by endoscopy or eyewitness
• • Purulent pleurisy, lung abscess, or other concomitant bacterial infection requiring antibiotic therapy.