PLUS-IS-LESS project: Procalcitonin and Lung UltraSonography-based antibiotherapy in patients with Lower rESpiratory tract infection in Swiss Emergency Departments: study protocol for a pragmatic stepped-wedge cluster-randomized trial.

Publication

PLUS-IS-LESS project: Procalcitonin and Lung UltraSonography-based antibiotherapy in patients with Lower rESpiratory tract infection in Swiss Emergency Departments: study protocol for a pragmatic stepped-wedge cluster-randomized trial.

Journal Paper/Review - Jan 25, 2024

Bessat Cécile, Bingisser Roland, Schwendinger Markus, Bulaty Tim, Fournier Yvan, Della Santa Vincent, Pfeil Magali, Schwab Dominique, Leuppi Joerg Daniel, Geigy Nicolas, Steuer Stephan, Roos Friedemann, Christ Michael, Sirova Adriana, Espejo Tanguy, Riedel Henk, Atzl Alexandra, Napieralski Fabian, Marti Joachim, Cisco Giulio, Foley Rose-Anna, Schindler Melinée, Hartley Mary-Anne, Fayet Aurélie, Garcia Elena, Locatelli Isabella, Albrich Werner, Hugli Olivier, Boillat-Blanco Noémie, PLUS-IS-LESS study group

Citation

Bessat C, Bingisser R, Schwendinger M, Bulaty T, Fournier Y, Della Santa V, Pfeil M, Schwab D, Leuppi J, Geigy N, Steuer S, Roos F, Christ M, Sirova A, Espejo T, Riedel H, Atzl A, Napieralski F, Marti J, Cisco G, Foley R, Schindler M, Hartley M, Fayet A, Garcia E, Locatelli I, Albrich W, Hugli O, Boillat-Blanco N, PLUS-IS-LESS study group. PLUS-IS-LESS project: Procalcitonin and Lung UltraSonography-based antibiotherapy in patients with Lower rESpiratory tract infection in Swiss Emergency Departments: study protocol for a pragmatic stepped-wedge cluster-randomized trial. Trials 2024; 25:86.

Type

Journal Paper/Review (English)

Journal

Trials 2024; 25

Publication Date

Jan 25, 2024

Issn Electronic

1745-6215

Brief description/objective

Lower respiratory tract infections (LRTIs) are among the most frequent infections and a significant contributor to inappropriate antibiotic prescription. Currently, no single diagnostic tool can reliably identify bacterial pneumonia. We thus evaluate a multimodal approach based on a clinical score, lung ultrasound (LUS), and the inflammatory biomarker, procalcitonin (PCT) to guide prescription of antibiotics. LUS outperforms chest X-ray in the identification of pneumonia, while PCT is known to be elevated in bacterial and/or severe infections. We propose a trial to test their synergistic potential in reducing antibiotic prescription while preserving patient safety in emergency departments (ED).