Impact on the Use of Antibiotics of a Multimodal Algorithm for the Diagnosis and Management of Acute Community-acquired Pneumonia in the Emergency Room (PROMCAP)
Community-acquired Pneumonia
About this trial
This is an interventional diagnostic trial for Community-acquired Pneumonia focused on measuring CRP dosage, multiplex PCR, chest scan without injection
Eligibility Criteria
Inclusion Criteria: Patient 18 years or older Presence of at least one respiratory sign among the following: dyspnea, cough, expectoration, auscultatory abnormalities, chest pain; Presence of at least one general sign among the following: fever (T>38°C), hypothermia (T<35°C), myalgia, headache, asthenia; Oxygen-requiring patient defined by a saturation <95% or presenting a risk area among: Age > 65 years old Alcoholic and/or tobacco intoxication Congestive heart failure Cerebrovascular disease (stroke or transient ischemic attack) Chronic kidney disease (excluding dialysis) Chronic liver disease Unbalanced diabetes mellitus Progressive neoplastic disease Immunodepression (systemic corticosteroid therapy or immunosuppressive treatment within 6 months, splenectomy, chemotherapy within 6 months, HIV at the AIDS stage, cachexia, etc.) Homozygous sickle cell disease Bacterial pneumonia Hospitalization during the year Institutional life Non-inclusion Criteria: Patient unable to consent: coma or acute respiratory distress requiring orotracheal intubation Patient with chronic renal failure on dialysis Patient with a history of chronic obstructive pulmonary disease Lung transplant patient Patient being treated with antibiotics at the time of the emergency room consultation Patient simultaneously participating in an interventional study protocol (assessing the duration of antibiotic therapy) Pregnant or breastfeeding woman Patient refusal to participate Patient deprived of freedom or under a legal protective measure Patient under guardianship or curatorship or with cognitive impairment Non-affiliation to a social security regimen or CMU Exclusion Criteria: • RT-PCR positive for SARS-CoV-2
Sites / Locations
- CHU NîmesRecruiting
- Bichat hospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Intervention period
Control period
Patient management will be guided by a multimodal algorithm integrating the performance of biological and iconographic examinations
Patient management will be done according to the usual practices of centers and emergency physicians