Titre
Impact of respiratory pathogens detection by a rapid multiplex polymerase chain reaction assay on the management of community-acquired pneumonia for children at the paediatric emergency department. A randomized controlled trial, the Optimization of Pneumonia Acute Care (OPTIPAC) study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Cantais, A.
Auteure/Auteur
Pillet, S.
Auteure/Auteur
Rigaill, J.
Auteure/Auteur
Angoulvant, F.
Auteure/Auteur
Gras-Le-Guen, C.
Auteure/Auteur
Cros, P.
Auteure/Auteur
Thuiller, C.
Auteure/Auteur
Molly, C.
Auteure/Auteur
Tripodi, L.
Auteure/Auteur
Desbree, A.
Auteure/Auteur
Annino, N.
Auteure/Auteur
Verhoeven, P.
Auteure/Auteur
Carricajo, A.
Auteure/Auteur
Bourlet, T.
Auteure/Auteur
Chapelle, C.
Auteure/Auteur
Claudet, I.
Auteure/Auteur
Garcin, A.
Auteure/Auteur
Izopet, J.
Auteure/Auteur
Mory, O.
Auteure/Auteur
Pozzetto, B.
Auteure/Auteur
Groupes de travail
OPTIPAC study group
Liens vers les personnes
Liens vers les unités
ISSN
1469-0691
Statut éditorial
Publié
Date de publication
2024-08-05
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Publication Status: aheadofprint
Résumé
The pathogen of community-acquired pneumonia (CAP) in children is typically uncertain during initial treatment, leading to systematic empiric antibiotic use. This study investigates if having rapid multiplex PCR results in the emergency department (ED) improves empiric treatment.
OPTIPAC, a French multicentre study (2016-2018), enrolled patients consulting for CAP at the paediatric ED in 11 centres. Patients were randomized to either receive a multiplex PCR test plus usual care or usual care alone and followed for 15 days. The primary outcome was the appropriateness of initial antimicrobial management, determined by a blinded committee.
Of the 499 randomized patients, 248 were tested with the multiplex PCR. Appropriateness of the antibiotic treatment was higher in the PCR group (168/245, 68.6% vs. 120/249, 48.2%; Relative risk 1.42 [1.22-1.66]; p < 0.0001), chiefly by reducing unnecessary antibiotics in viral pneumonia (RR 3.29 [2.20-4.90]). No adverse events were identified.
The multiplex PCR assay result at the ED improves paediatric CAP's antimicrobial stewardship, by both reducing antibiotic prescriptions and enhancing treatment appropriateness.
OPTIPAC, a French multicentre study (2016-2018), enrolled patients consulting for CAP at the paediatric ED in 11 centres. Patients were randomized to either receive a multiplex PCR test plus usual care or usual care alone and followed for 15 days. The primary outcome was the appropriateness of initial antimicrobial management, determined by a blinded committee.
Of the 499 randomized patients, 248 were tested with the multiplex PCR. Appropriateness of the antibiotic treatment was higher in the PCR group (168/245, 68.6% vs. 120/249, 48.2%; Relative risk 1.42 [1.22-1.66]; p < 0.0001), chiefly by reducing unnecessary antibiotics in viral pneumonia (RR 3.29 [2.20-4.90]). No adverse events were identified.
The multiplex PCR assay result at the ED improves paediatric CAP's antimicrobial stewardship, by both reducing antibiotic prescriptions and enhancing treatment appropriateness.
PID Serval
serval:BIB_8B8C4FF28937
PMID
Date de création
2024-11-04T13:28:03.097Z
Date de création dans IRIS
2025-05-20T23:05:18Z