Reduction of Antibiotic Therapy by Biomakers in Patients With CAP Episodes (REDUCE Study) (REDUCE)
Community Acquired Pneumonia
About this trial
This is an interventional treatment trial for Community Acquired Pneumonia
Eligibility Criteria
Inclusion Criteria:
Male and female patients with a diagnosis of CAP and all criteria listed below:
- Age 18 or above, no upper age limit will be employed.
- Patients must require hospitalisation.
Clinical presentation of an acute illness with one or more of the following symptoms:
- Temperature ≥ 38.0 ⁰C (100.4°F)
- Dyspnoea
- Cough (with or without expectoration of sputum)
- Chest pain
- Malaise or fatigue
- Myalgia
- Gastro-intestinal symptoms
- Rales, rhonchi or wheezing
- Egophony or bronchial breath sounds
- New consolidation(s) on the chest radiograph.
- Written informed consent obtained.
- (Pre-event) Life expectancy > 30 days
Exclusion Criteria:
Subjects presenting with any of the following will not be included in the study:
- (Severe) immunosuppression (e.g. HIV infection, chemotherapy, use of immunosuppressants).
- Active neoplastic disease.
- Obstruction pneumonia (e.g. from lung cancer).
- Aspiration pneumonia.
- Pneumonia that developed within 8 days after hospital discharge.
- Unable and/or unlikely to comprehend and/or follow the protocol.
- Pregnant and/or lactating women.
- Other infection that requires treatment with antibiotics
Sites / Locations
- Medical Centre Alkmaar
- Slotervaart Hospital
- ISALA clinics
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Experimental
Experimental
Common clinical practice
CRP-guided treatment
PCT guided treatment
Treatment according to current guidelines. Often a 7 day course of antibiotics. Initial treatment should be broad spectrum antibiotics and can be narrowed down if a specific pathogen is identified.
Treatment according to CRP levels. Patients will be started on broad spectrum antibiotics for at least 3 days, treatment can be switched to small-spectrum antibiotics if a specific pathogen is identified. From day 4 to 7 daily blood tests will be performed in order to evaluate whether or not treatment can be discontinued. If treatment is discontinued, no more blood tests will be performed.
Treatment according to PCT levels. Patients will be started on broad spectrum antibiotics for at least 3 days, treatment can be switched to small-spectrum antibiotics if a specific pathogen is identified. From day 4 to 7 daily blood tests will be performed in order to evaluate whether or not treatment can be discontinued. If treatment is discontinued, no more blood tests will be performed.