Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: CLINPCT Study: Clinical Reassessment Versus Procalcitonin-guided Algorithm in Order to Reduce Antibiotic Consumption in Community-acquired Pneumonia
Brief Summary: CLINPCT study is a prospective, randomized, controlled, open intervention clinical trial including adult patients admitted in the emergency department with community-acquired pneumonia. The objective of this clinical trial is to compare two strategies: clinical reassessment and procalcitonin guided diagnostic and therapeutic strategy in patients with community-acquired pneumonia. In the clinical reassessment arm, antibiotherapy is systematically started in the emergency department. The continuation, the discontinuation or the modification of the antibiotherapy initially prescribed in the ED were made at Day 1 and Day 5 based on clinical assessment. On Day 1, the aim of the clinical reassessment is diagnosis reassessment: to confirm or not the diagnosis of community-acquired pneumonia and to confirm or not the antibiotherapy. On Day 5, the aim of the clinical reassessment is to evaluate the possibility to stop the current antibiotherapy based on criteria for clinical stability defined by the Infectious Diseases Society of America (Temperature ≤37.8°C, Heart rate ≤100 beats/min, Respiratory rate ≤24 breaths/min, Systolic blood pressure ≥90 mm Hg, Arterial oxygen saturation ≥90% or pO2 ≥60 mm Hg on room air). In the procalcitonin arm, initiation and discontinuation of the antibiotherapy is based on the antibiotic stewardship based on procalcitonin (PCT) cut-off ranges previously published. Re-evaluation of the clinical status and measurement of serum PCT levels is mandatory after 6-24 h in all persistently sick and hospitalized patients in who antibiotic are withheld. The PCT algorithm can be overruled by pre-specified criteria, e.g. in patients with immediately life-threatening disease. If the algorithm is overruled and antibiotics are given, an early discontinuation of antibiotic therapy after 3, 5 or 7 days is more or less endorsed based on PCT levels. In hospitalized patients with ongoing antibiotic therapy PCT levels are reassessed on days 3, 5 and 7 and antibiotics will be discontinued using the PCT cut-offs defined above.


Options:
A: Arm Label: CRP intervention; Type: EXPERIMENTAL; Interventions: Procedure: Patients will be tested by rapid POC CRP test | Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: PROCEDURE; Name: Patients will be tested by rapid POC CRP test; Assigned to Arm(s): CRP intervention
B: Arm Label: PCT guidance; Type: OTHER; Interventions: Other: the procalcitonin arm | Arm Label: clinical reassessment; Type: OTHER; Interventions: Other: the clinical reassessment arm | Intervention Type: OTHER; Name: the clinical reassessment arm; Assigned to Arm(s): clinical reassessment | Intervention Type: OTHER; Name: the procalcitonin arm; Assigned to Arm(s): PCT guidance
C: Arm Label: Antibiotic use feedback letter 1; Type: ACTIVE_COMPARATOR; Interventions: Other: Antibiotic use feedback letter | Arm Label: Antibiotic use feedback letter 2; Type: ACTIVE_COMPARATOR; Interventions: Other: Antibiotic use feedback letter | Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: Antibiotic use feedback letter; Assigned to Arm(s): Antibiotic use feedback letter 1, Antibiotic use feedback letter 2
D: N/A

Answer: B