Early Molecular Detection Technique Coupled With Urinary Test of Infectious Agents Responsible of Children CAP
Condition: Community-Acquired Pneumonia
MeSH terms: Pneumonia; Communicable Diseases; Infections
Study type: Interventional

Summary: 
      Community-Acquired Pneumonia (CAP) of children are a recurrent pathology with multiple
      severity scores. The etiology is never really identified, and the initial treatment is always
      based on probabilistic antibiotics, in the case of an bacterial infection, and by the way,
      potentially severe.

      Molecular tests ("multiplex") allow the simultaneous detection of a huge number of pathogenic
      agents, virus and bacteria, are now available.

      This project is based on a new strategy of diagnostic, using a multiplex PCR with quick
      results, coupled to an antigenic urinary test to allow a complete, quick, etiologic
      diagnostic as soon as children are supported in emergency.

      Children are randomized in two groups during inclusions : quick diagnostic strategy versus
      usual practice. Analyse will be centralized on anti-infectious treatment optimization, with
      the aim to better treat patients, minimize the costs, and decrease selection pressure of
      multi-resistant bacteria.
    

Detailed description: 
      Community-Acquired Pneumonia (CAP) of children are a recurrent pathology with multiple
      severity scores. Almost two out of three cases identified at emergency are treated in
      ambulatory because patients present a reassuring clinical state. The etiology is never really
      identified, and the initial treatment is always based on probabilistic antibiotics
      re-evaluated at H48, in the case of an bacterial infection, and by the way, potentially
      severe. This old conception is opposed to the new discoveries, more particularly in pediatric
      units where strictly viral pneumonia are more important than predicted (at least 30 to 50%)
      that leads to an hyper prescription of antibiotics, useless.

      Molecular tests ("multiplex") allow the simultaneous detection of a huge number of pathogenic
      agents, virus and bacteria, are now available.

      Aware of the non specificity of the clinical data to guide the diagnostic, this project is
      based on a new strategy of diagnostic, using a multiplex PCR with quick results (less than 2
      hours, for 20 pathogens, including 17 viruses) coupled to an antigenic urinary test to allow
      a complete, quick, etiologic diagnostic as soon as children are supported in emergency.

      Children are randomized in two groups during inclusions : quick diagnostic strategy versus
      usual practice. Analyse will be centralized on anti-infectious treatment optimization
      (antibiotics and antiviruses), with the aim to better treat patients, minimize the costs, and
      decrease selection pressure of multi-resistant bacteria.
    

Intervention name(s): OptiPAC; Usual care
Intervention type(s): Other; Other
Intervention description(s): Molecular and urinary tests.; Antibiotics for prevention.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic