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

Hôpital Louis Mourier181 enrolled

Overview

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.

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.

Study Type

OBSERVATIONAL

Enrollment

181

Conditions

Community-acquired Pneumonia

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

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

Locations (4)

Centre Hospitalier Victor Dupouy

Argenteuil, France

Louis Mourier Hospital

Colombes, France

Hôpital Max Fourestier

Nanterre, France

Tenon Hospital

Paris, France

Outcomes

Primary Outcomes

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;

Time frame: 28 days

Secondary Outcomes

pneumonia severity index

the pneumonia severity index calculated at inclusion will be compared in exposed and non-exposed to NSAID patients

Time frame: 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

Time frame: 2 days

duration of antimicrobial therapy

Time frame: 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

Time frame: 28 days

28-day mortality

Time frame: 28 days

Data from ClinicalTrials.gov

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