Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Impact of rapid molecular testing on diagnosis, treatment and management of community-acquired pneumonia in Norway: a pragmatic randomised controlled trial (CAPNOR)

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Prevalence of biofilms in acute infections challenges a longstanding paradigm

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Rapid syndromic PCR testing in patients with respiratory tract infections reduces time to results and improves microbial yield

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Endotracheal lactate reflects lower respiratory tract infections and inflammation in intubated patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Increased sputum lactate during oral glucose tolerance test in cystic fibrosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • CAPNOR study group
View graph of relations

BACKGROUND: Community-acquired pneumonia (CAP) causes a large burden of disease. Due to difficulties in obtaining representative respiratory samples and insensitive standard microbiological methods, the microbiological aetiology of CAP is difficult to ascertain. With a few exceptions, standard-of-care diagnostics are too slow to influence initial decisions on antimicrobial therapy. The management of CAP is therefore largely based on empirical treatment guidelines. Empiric antimicrobial therapy is often initiated in the primary care setting, affecting diagnostic tests based on conventional bacterial culture in hospitalized patients. Implementing rapid molecular testing may improve both the proportion of positive tests and the time it takes to obtain test results. Both measures are important for initiation of pathogen-targeted antibiotics, involving rapid de-escalation or escalation of treatment, which may improve antimicrobial stewardship and potentially patient outcome.

METHODS: Patients presenting to the emergency department of Haukeland University Hospital (HUH) in Bergen, Norway, will be screened for inclusion into a pragmatic randomised controlled trial (RCT). Eligible patients with a suspicion of CAP will be included and randomised to receive either standard-of-care methods (standard microbiological testing) or standard-of-care methods in addition to testing by the rapid and comprehensive real-time multiplex PCR panel, the BioFire® FilmArray® Pneumonia Panel plus (FAP plus) (bioMérieux S.A., Marcy-l'Etoile, France). The results of the FAP plus will be communicated directly to the treating staff within ~2 h of sampling.

DISCUSSION: We will examine if rapid use of FAP plus panel in hospitalized patients with suspected CAP can improve both the time to and the proportion of patients receiving pathogen-directed treatment, thereby shortening the exposure to unnecessary antibiotics and the length of hospital admission, compared to the standard-of-care arm. The pragmatic design together with broad inclusion criteria and a straightforward intervention could make our results generalizable to other similar centres.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04660084 . Registered on December 9, 2020.

Original languageEnglish
Article number622
JournalTrials
Volume23
Issue number1
Pages (from-to)622
ISSN1745-6215
DOIs
Publication statusPublished - 1 Aug 2022

Bibliographical note

© 2022. The Author(s).

    Research areas

  • Anti-Bacterial Agents/therapeutic use, Anti-Infective Agents, Community-Acquired Infections/diagnosis, Humans, Molecular Diagnostic Techniques, Pneumonia/diagnosis

ID: 80062177