Clinical trial: Procalcitonin for Stewardship in Respiratory Infections A Stewardship Project (NCT03109106)

Eligibility criteria:
Inclusion Criteria:

          -  Candidate patients will have evidence of an acute lower respiratory tract infection
             (pneumonia or acute exacerbation of chronic bronchitis) as defined as follows:

             o NEW onset within past 28 days

          -  At least one respiratory symptom: cough, sputum production, dyspnea, tachypnea,
             pleuritic chest pain, wheezing

        PLUS: At least one :

          -  auscultation abnormality suggestive of pneumonia (rales, ronchi, egophony)

          -  OR a new consolidation on chest radiology consistent with pneumonia

          -  OR at least one sign of systemic infection: fever >38.1 or WBC >10,000 or <4,000 AND
             provider initiating empiric antibiotics

        Exclusion Criteria:

          -  - Age <18

          -  Microbiologically documented infections caused by organisms for which a prolonged
             duration is standard of care (i.e. Pseudomonas, Acinetobacter, Listeria, Legionella,
             Pneumocystis, M. tuberculosis, Non-tuberculous mycobacterium (NTM) infection, S.
             aureus pneumonia or cavitary pneumonia)

          -  Severe infections due to viruses and parasites with a risk of bacterial translocation
             (hemorrhagic fever, malaria)

          -  Infectious conditions requiring prolonged therapy: endocarditis, brain abscess, deep
             abscess

          -  Antibiotics already started 24 hours prior to initial PCT value

          -  Chronic localized infections (i.e. chronic osteomyelitis, mediastinitis, brain
             abscess)

          -  Severely immunocompromised patients (HIV with CD4<200, neutropenic with absolute
             neutrophil count (ANC) <500, patients on immunosuppressive therapy after solid organ
             transplantation or those with autoimmune disease (corticosteroids allowed but no more
             than 20 mg/day (prednisone equivalent) for 14 days). Cystic fibrosis

          -  Active IV drug abuse

          -  Pregnant patients

          -  Patients lacking capacity to consent

          -  Patients admitted for burn injuries

          -  Patients within 30 days of major intra-thoracic or intra-abdominal surgery

          -  Patients receiving antibiotics for a non-respiratory infection
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 100 Years

Patient description (medical language): A 30-year-old man who is a computer scientist came to the clinic with the lab result stating azoospermia.  The patient is sexually active with his wife and does not use any contraception methods.  They have been trying to conceive for the past year with no success.  The patient has a past medical history of recurrent pneumonia, shortness of breath, and  persistent cough that produces large amounts of thick sputum. The patient had multiple lung infections during childhood. He does not smoke, use illicit drugs or alcohol.  The patient has no history of other medical conditions including allergies or any kind of surgery.  On physical examination, the digits show clubbing.  An ultrasound shows bilateral absence of the vas deferens, and FEV1 was 75% on the respiratory function test.

Patient description (patient's own words): I'm a 30-year-old computer scientist. I did some lab tests that came back quite alarming, stating that I have azoospermia?! I'm sexually active with my wife and we don't use contraception. We've been trying to have a child for the past year. I have a medical history of pneumonia and shortness of breath and regular wet cough. I had several lung infections when I was a kid. That's why I'm very careful and don't smoke, do drugs, or drink. I don't have other medical conditions including allergies or any kind of surgery. The doctor did the clubbing test on my fingers, which was positive. I also did an ultrasound and it showed that I'm missing the tubes that carry sperm around. I also had a 75% for my respiratory function test.

Does the patient match the trial criteria? Contradiction