Use of a Respiratory Multiplex PCR and Procalcitonin to Reduce Antibiotics Exposure in Patients With Severe Confirmed COVID-19 Pneumonia (MultiCov)
Covid19, Pneumonia
About this trial
This is an interventional treatment trial for Covid19 focused on measuring COVID-19 pneumonia, respiratory multiplex PCR, Procalcitonin, Antibiotics saving, Diagnosis, Treatment
Eligibility Criteria
Inclusion Criteria:
- Adults (>= 18 years) admitted to the ICU;
- Severe confirmed COVID-19 pneumonia, defined by i) a newly-appeared pulmonary parenchymal infiltrate; and ii) a positive RT-PCR (either upper or lower respiratory tract) for COVID-19 (SARS-CoV-2); iii) and admission to the ICU or intermediate care unit;
- Informed consent or emergency procedure.
Exclusion Criteria:
- Pregnancy ;
- Congenital immunodeficiency;
- HIV infection with CD4 count below 200/mm3 or unknown in the last year;
- High-grade hematological malignancy;
- Neutropenia (<1 leucocyte/mL or < 0.5 neutrophil/mL);
- Immunosuppressive drugs within the previous 30 days, including anti-cancer cytotoxic chemotherapy and anti-rejection drugs for organ/bone marrow transplant;
- Moribund patient or death expected from underlying disease during the current admission;
- Patient deprived of liberty or under legal protection measure
Sites / Locations
- Intensive care department-Hospital Tenon
Arms of the Study
Arm 1
Arm 2
Experimental
Other
Targeted antibiotic treatment according to the results of mPCR
Control arm
a broad panel respiratory Mpcr FA-PPP is performed on respiratory tract sample (tracheal aspirate, BAL or sputum), collected 12 hours after inclusion. An algorithm of early antibiotic adaptation and discontinuation, based on the microbiological results, including the mPCR FA-PPP results, and the procalcitonin values and kinetics will be used. This algorithm will be applied as soon as possible after inclusion, and repeated day after day until D7.
The antimicrobial therapy is left at the discretion of the physicians, as in usual practice.