Use of Non Steroidal Antiinflammatory Drugs in Patients With Community Acquired Pneumonia

Study Overview
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Brief Summary
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To investigate exposure to nonsteroidal antiinflammatory drugs (NSAIDs) during outpatient management at the early stage of community-acquired pneumonia (CAP) requiring hospital consultation. Non-interventional observational study.

Detailed Description
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Recent data suggests that such exposure to NSAIDs is associated with delay in CAP diagnosis and antibiotic prescription that influence CAP presention and outcome. The investigators' working hypothesis is that NSAIDs use may mask initial symptoms and delay antimicrobial therapy, thus predisposing to worse outcomes. All patients presenting at one of the three following locations (emergency department, ICU or pneumology ward) with a suspicion of community-acquired pneumonia will be screened for eligibility. Exposure or not to NSAIDs will be investigated. Clinical, biological and radioloigcal features and outcome of CAP will be compared with respect to NSAIDs exposure.

Official Title
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Descriptive Analysis of Non Steroidal Antiinflammatory Drugs Use in Patients Diagnosed With Community Acquired Pneumonia

Conditions
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Community-acquired Pneumonia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: at least two among the following signs temperature > 37.8 °C respiratory rate > 25/min heat rate > 100/min cough expectoration chest pain crackles upon lung auscultation and new infiltrate on the chest x-ray Exclusion Criteria: ongoing pregnancy sickle cell disease tracheostomy long term oxygen therapy cystic fibrosis or bronchiectasis neutropenia (< 500 cells/mm3) ongoing solid or hematologic cancer or anticancerous chemotherapy HIV infection liver cirrhosis long term corticosteroid treatment (20mg per day equivalent prednisone for more than 15 days) preexisting treatment with NSAIDs for more than 15 days hospital admission for more than 48hours aspiration pneumonia

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| binary composite primary endpoint | presence or absence of one or more of the following : occurrence of at least one pneumonia-related complication; need for ICU admission; prolonged length of hospital stay. pneumonia-related complications include: worsening of hypoxemia; need for mechanical ventilation; occurrence or increase of pleural effusion; empyema; occurrence of septic shock; | 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pneumonia severity index | the pneumonia severity index calculated at inclusion will be compared in exposed and non-exposed to NSAID patients | 2 days | 
| CURB score at inclusion | the CURB score (confusion, blood urea nitrogen, respiratory rate and systolic blood pressure) at inclusion will be compared in exposed and non-exposed to NSAID patients | 2 days | 
| duration of antimicrobial therapy |  | 28 days | 
| occurence of a nosocomial infection | occurrence of nosocomial infections (including nosocomial pneumonia, catheter-related blood stream infection, and urinary tract nosocomial infection) will be compared in exposed and non-exposed to NSAID patients | 28 days | 
| 28-day mortality |  | 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pneumonia, Bacterial [C01.252.620], Bronchopneumonia [C08.381.677.127], Pleuropneumonia [C08.730.610.473], Anti-Inflammatory Agents, Non-Steroidal