Lower respiratory tract infection (LRTI) Respiratory
Conditions
Interventions
The BIOFIRE® FILMARRAY® Pneumonia plus Panel tests for 18 bacteria (11 Gram-negative, 4 Gram-positive and 3 atypical), 7 antibiotic resistance markers, and 9 viruses that cause pneumonia and other low
Sponsors
University Hospital of Basel
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Age =18 years 2. Clinical indication for diagnostic bronchoscopy with bronchoalveolar lavage 3. Suspicion of lower respiratory tract infection – in immunocompetent patients infiltrate must be confirmed; in immunocompromised patients an infiltrate is not required 4. Evidence of systemic inflammation (such as abnormal white blood cell count – either leukocytosis (>10.0x10e9/l) or leukopenia (<4.0x10e9/l) – or C-reactive protein (CRP) or procalcitonin (PCT) values above the local upper limit
Exclusion criteria
Exclusion criteria: 1. Ambulatory patients 2. Patients intubated at the time of inclusion 3. Neutropenic patients as defined by neutrophils <0.5x10e9/l 4. Haemodynamic instability or signs of life-threatening infection precluding a narrowing of antimicrobial therapy 5. Prior enrolment in an intervention study within the last 30 days 6. Women who are pregnant or breastfeeding
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time on inappropriate therapy in hours, recorded daily up to a total of 30 days, defined as anti-microbial therapy: 1. With no identifiable pathogen or 2. Not active according to in-vitro susceptibility testing of the identified pathogen or 3. With known intrinsic resistance of the identified pathogen to the given therapy or 4. Having a spectrum too broad for the identified pathogen (antimicrobial therapy considered broad when switching to a different antimicrobial therapy with a narrower spectrum continues to show a favourable clinical course) and in the case where there is a lack of evidence suggesting resistance of the microorganism to a narrower antimicrobial therapy or 5. Continuation of the antimicrobial therapy beyond the guideline-suggested duration e.g. for pneumonia 5 to 7 days | — |
Secondary
| Measure | Time frame |
|---|---|
| Clinical outcomes measured using patients’ medical records daily up to a total of 30 days: 1. Time to clinical stability (in hours) 2. Length of hospital stay (in hours) 3. Mortality 4. Adverse events | — |
Countries
Germany, Switzerland
Outcome results
None listed