Community-acquired Pneumonia
Conditions
Keywords
Pneumonia, Bacterial [C01.252.620], Bronchopneumonia [C08.381.677.127], Pleuropneumonia [C08.730.610.473], Anti-Inflammatory Agents, Non-Steroidal
Brief summary
To investigate exposure to nonsteroidal antiinflammatory drugs (NSAIDs) during outpatient management at the early stage of community-acquired pneumonia (CAP) requiring hospital consultation. Non-interventional observational study.
Detailed description
Recent data suggests that such exposure to NSAIDs is associated with delay in CAP diagnosis and antibiotic prescription that influence CAP presention and outcome. The investigators' working hypothesis is that NSAIDs use may mask initial symptoms and delay antimicrobial therapy, thus predisposing to worse outcomes. All patients presenting at one of the three following locations (emergency department, ICU or pneumology ward) with a suspicion of community-acquired pneumonia will be screened for eligibility. Exposure or not to NSAIDs will be investigated. Clinical, biological and radioloigcal features and outcome of CAP will be compared with respect to NSAIDs exposure.
Interventions
None listed
Sponsors
Hôpital Louis Mourier
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
at least two among the following signs * temperature \> 37.8 °C * respiratory rate \> 25/min * heat rate \> 100/min * cough * expectoration * chest pain * crackles upon lung auscultation and new infiltrate on the chest x-ray
Exclusion criteria
* ongoing pregnancy * sickle cell disease * tracheostomy * long term oxygen therapy * cystic fibrosis or bronchiectasis * neutropenia (\< 500 cells/mm3) * ongoing solid or hematologic cancer or anticancerous chemotherapy * HIV infection * liver cirrhosis * long term corticosteroid treatment (20mg per day equivalent prednisone for more than 15 days) * preexisting treatment with NSAIDs for more than 15 days * hospital admission for more than 48hours * aspiration pneumonia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| binary composite primary endpoint | 28 days | presence or absence of one or more of the following : occurrence of at least one pneumonia-related complication; need for ICU admission; prolonged length of hospital stay. pneumonia-related complications include: worsening of hypoxemia; need for mechanical ventilation; occurrence or increase of pleural effusion; empyema; occurrence of septic shock; |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| CURB score at inclusion | 2 days | the CURB score (confusion, blood urea nitrogen, respiratory rate and systolic blood pressure) at inclusion will be compared in exposed and non-exposed to NSAID patients |
| duration of antimicrobial therapy | 28 days | — |
| occurence of a nosocomial infection | 28 days | occurrence of nosocomial infections (including nosocomial pneumonia, catheter-related blood stream infection, and urinary tract nosocomial infection) will be compared in exposed and non-exposed to NSAID patients |
| 28-day mortality | 28 days | — |
| pneumonia severity index | 2 days | the pneumonia severity index calculated at inclusion will be compared in exposed and non-exposed to NSAID patients |
Other
| Measure | Time frame | Description |
|---|---|---|
| chest pain | 2 days | presence or absence of chest pain at inclusion will compared between exposed and non-exposed to NSAID patients |
Countries
France
Outcome results
None listed