Lower Respiratory Tract InfectionPLUS-IS-LESSNCT05463406
Procalcitonin and Lung Ultrasonography Guided Antibiotherapy in Emergency Departments
A study testing The PLUS algorithm in people with Lower Respiratory Tract Infection, run by Dr Boillat-Blanco Noemie at 9 sites in Switzerland.
Trial summary
Acute respiratory infections are a common reason of attendance at emergency departments. It is also the main reason of unnecessary antibiotic prescription. Antibiotics save lives, but can also directly harm patients by causing antibiotic-associated adverse events. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Lower Respiratory Tract Infection
- What is being tested?
- The PLUS algorithm
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,407 participants
- Where
- 9 sitesSwitzerland
- Study dates
- 5 Dec 2022to 11 Jun 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed informed consent
- Patients aged 18 years or more
- Acute LRTI (acute illness, less than 21 days, with at least one lower respiratory tract symptom, i.e. cough, sputum, dyspnea, chest pain and no alternative explanation)
- At least one of the following clinical criteria:
- Focal abnormal auscultation (decreased breath sounds, crackles, bronchial breath sounds)
- Fever (documented temperature ≥ 38°C in the last 24 hours, including self-measured temperature ≥ 38°C)
- Tachypnea (respiratory rate ≥ 22/minute)
- Tachycardia (heart rate ≥ 100/minute)
Who cannot join
- Previous receipt of a quinolone, macrolide or ceftriaxone or, of more than one dose of any other antibiotic within 72h prior to enrolment (excepted prophylactic antibiotics or antibiotics given for urinary tract infection)
- Previous hospital stay in the last 14 days
- Cystic fibrosis
- Severe COPD (≥GOLD 3 or if not available, as a proxy: exacerbation treated with antibiotics during the last 6 months)
- Severe immunodeficiency (drug-induced neutropenia with <500 neutrophils/mm3, HIV infection with CD4<200 cells/mm3, solid organ or bone marrow transplant recipient, prednisone ≥ 20mg/day for >28 days)
- Initial admission of the patient in the intensive care unit
- Microbiologically-documented SARS-CoV-2
- Incapacity of discernment
Trial locations and contacts
9 sites in 1 country.
9 sites in 1 country
Switzerland9 sites
Cantonal hospital of Baden
Baden, Canton of Aargau, 5404
University Hospital of Basel
Basel, Canton of Basel-City, 4031
Centre hospitalier universitaire vaudois (CHUV)
Lausanne, Canton of Vaud, 1011
Kantonsspital Baselland
Liestal, Canton of Basel-City, 4410
Luzerner Kantonsspital
Lucerne, Canton of Lucerne, 6000
Réseau Hospitalier Neuchâtelois
Neuchâtel, Canton of Neuchâtel, 2000
Hôpital Intercantonal de la Broye
Payerne, Canton of Vaud, 1530
Hôpital Riviera-Chablais
Rennaz, Canton of Vaud, 1847
Cantonal Hospital of St. Gallen
Sankt Gallen, Canton of St. Gallen, 9007
About this study
Official title: Procalcitonin and Lung Ultrasonography Based Antibiotherapy in Patients With Lower Respiratory Tract Infection in Swiss Emergency Departments: Pragmatic Stepped-wedge Cluster-randomized Trial
Acute respiratory infections are a common reason of attendance at emergency departments. It is also the main reason of unnecessary antibiotic prescription. Antibiotics save lives, but can also directly harm patients by causing antibiotic-associated adverse events. Antibiotic use is directly related to resistance, which is one of the major threats of our century. In addition, some microorganisms live in and on the human body and promote many aspects of our health. Antibiotic treatment can disturb those microorganisms and therefore have long-lasting negative effects on our health.
Unfortunately, it is difficult to differentiate between viral infections, which usually heal spontaneously, and bacterial pneumonia, which needs antibiotics treatment. This is one of the reasons of this over-prescribing of antibiotics.
Read more
This project aims to reduce widespread use of antibiotics in the emergency department through a new diagnostic strategy of bacterial pneumonia. This strategy includes sequential use of well-known techniques: a clinical score, lung ultrasound and finally a biomarker, procalcitonin. The latter tends to be higher in bacterial infections. The combination of these different tests improves the diagnostic process and allows improved use of targeted antibiotics, with the ultimate goal of better patient management.
The study will compare the antibiotic prescription rate and the clinical course of patients managed using this new diagnostic approach with those managed as usual. The project will also evaluate the acceptability and feasibility of this strategy and its cost-effectiveness. These two aspects are essential for a wider implementation of this innovative diagnostic approach and decrease antibiotic resistance.
Read the detailed description
Background Community-acquired lower respiratory tract infections (LRTI) are one of the most common motivations for emergency department (ED) consultations and stands as the leading cause of inappropriate antibiotic prescription. Besides the side effects, antibiotic overuse alters the microbiome and generates antibiotic resistance. When assessing patients with LRTIs, the challenge for ED physicians is to identify those with community-acquired pneumonia (CAP) of bacterial origin, who will most likely benefit from antibiotics. The low diagnostic accuracy of existing tools, as well as the poor adherence of clinicians to test guidance are leading causes of inappropriate antibiotic use.
Several diagnostic tests can assist in identifying patients with LRTI who require antibiotics. Clinical prediction score can refine the probability of CAP. Lung ultrasound (LUS) has a better diagnostic performance than chest X-ray, the historic reference imaging modality to consolidation in ED. LUS is performed quickly at the bedside without radiation. Procalcitonin (PCT) is a host inflammatory biomarker which tends to be higher in bacterial infections. PCT can be used safely to guide antibiotics use, while its impact on prescription is controversial. None of these tools on its own is sufficient to optimize antibiotic prescription, while a combined approach could better guide clinicians.
Rationale The investigators propose to evaluate the use of a decision support tool to guide antibiotics use in the ED as the summative value of LUS with PCT remains unknown in this setting.
Pragmatic stepped-wedge cluster-randomized controlled clinical trial investigating a new algorithm combining a clinical score, LUS and PCT results (The PLUS algorithm) for the management of LRTIs among adults in EDs. The unit of randomization will be the ED.
Primary safety objective To demonstrate non-inferiority of the intervention in terms of clinical failure by day 28.
Co-primary efficacy objective To show a 15% reduction in the proportion of patients with LRTIs prescribed an antibiotic by day 28 in the intervention group compared with the usual care group.
Secondary objectives
- To compare the quality of life (bothersomeness of CAP-related symptoms) on day 7, day 28 and day 90 between patients in the intervention and control groups.
- To evaluate the acceptability and feasibility of the intervention through the identification of barriers and facilitators in patients and physicians.
- To assess the incremental cost-effectiveness of the intervention as compared to usual care using a within-trial (short-term), and a model-based (long-term) economic evaluation.
- To develop an advanced automatic LUS image analysis method using machine learning to assist in LUS diagnosis and risk stratification.
- Conditions
- Lower Respiratory Tract Infection
- Being tested
- The PLUS algorithm, Usual care
- Keywords
- pneumonia, lung ultrasonography, procalcitonin, clinical prediction score, antimicrobial stewardship
- Medical subject headings
- Pneumonia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
The PLUS algorithmOther
Combination of a clinical prediction score and LUS, and if needed PCT measurement
Usual careOther
Management as usual
| Study group | Role | What they receive |
|---|---|---|
| The PLUS algorithm | Experimental | The PLUS clinical management algorithm:
EDs having switched to the intervention period (intervention group) will manage their patients using the PLUS algorithm.
The PLUS algorithm starts with a validated pneumonia clinical prediction score (score of Van Vugt), followed by LUS. In case of positive results of any of these tests, PCT is measured to identify patients who will most likely benefit from antibiotics. A validated clinical severity score will ensure the safety of the intervention in those with discordant results (LUS consolidation and low PCT). Receives: Other: The PLUS algorithm |
| Usual care | Other | Usual care: management as usual Receives: Other: Usual care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Safety outcome
Proportion of patients with clinical failure (defined as a composite of any of the following: death or secondary ICU admission or secondary admission to hospital or hospital re-admission after index hospital discharge or complications due to the LRTI [empyema, lung abscess])
Measured: Day 28
Efficacy outcome
Proportion of patients prescribed an antibiotic in each intervention group between enrolment and day 28
Measured: Day 28
Secondary outcomes (9)
Quality of life measured with the community-acquired pneumonia symptom questionnaire
Number of points on the community-acquired pneumonia symptom questionnaire as a surrogate marker of quality of life (range 0 to 90; 90 beeing the worse quality of life)
Measured: Day 7, Day 28, Day 90
Hospitalisation
Duration of hospitalisation
Measured: Day 0 to Day 90
Efficacy endpoint
Proportion of patients prescribed an antibiotic in each study group between enrolment and day 28 as well as day 90.
Measured: Day 90
Antibiotic side effects and C. difficile infection
Proportion of patients with antibiotic-related side effects and C. difficile infections in each study group.
Measured: Day 0 to Day 28
Emergency department stay
Length of stay in the emergency department in each study group.
Measured: Day 0 to Day 28
Qualitative evaluation
Acceptability and feasibility of the intervention through extensive identification of barriers and facilitators in patients and physicians conducting qualitative semi-structured interviews
Measured: Day 90
Machine learning of Lung ultrasonography (LUS) images and videos
Diagnostic performance for pneumonia (sensitivity, specificity, AUROC) of artificial intelligence LUS interpretation using expert interpretation as gold standard
Measured: Day 90
Economic evaluation
Cost of the intervention as compared to usual care
Measured: Day 90
Clinical gestalt
Diagnostic performance (sensitivity, specificity, AUROC) of the "Clinical gestalt" of the physician in charge of the patient (probability of pneumonia low/intermediate versus high) versus Van Vugt score (1×absence of runny nose+1×breathlessness+1×crackles+1×diminished vesicular breathing+1×raised pulse (>100/min)+1×fever (temperature >37.8°C: probability of pneumonia low/intermediate (score 0-2 ) versus high (score>=3)) to predict LUS-visualized pneumonia
Measured: Day 0
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Jul 2022
- Study start5 Dec 2022
- Primary completion15 Mar 2025
- Study completion11 Jun 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Lower Respiratory Tract InfectionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Sequential
- Model description
- Pragmatic stepped-wedge cluster-randomized controlled clinical trial investigating a new algorithm combining a clinical score, LUS and PCT results (The PLUS algorithm) for the management of LRTIs among adults in EDs. The unit of randomization will be the ED.
- Masking
- None (open label)
- Enrolment
- 1,407 participants (actual)
Sponsor and investigators
- Lead sponsor
- Dr Boillat-Blanco Noemie
- Sponsor type
- University, hospital or other
- Collaborators
- Cantonal Hospital of St. Gallen, University Hospital, Basel, Switzerland, Kantonsspital Baden, Hôpital Intercantonal de la Broye, Payerne, Switzerland, Réseau Hospitalier Neuchâtelois, Hôpital Riviera-Chablais, Vaud-Valais, Luzerner Kantonsspital, Cantonal Hospital, Baselland, St. Claraspital AG
- Responsible party
- Sponsor-investigator, Dr Boillat-Blanco Noemie, Centre Hospitalier Universitaire Vaudois
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05463406
- Sponsor's protocol ID
- PLUS-IS-LESS
- Other IDs
- SNSF 33IC30_201300
- Acronym
- PLUS-IS-LESS
- Status last verified
- Apr 2025
- First submitted
- 8 Jul 2022
- Last updated
- 24 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Lamping DL, Schroter S, Marquis P, Marrel A, Duprat-Lomon I, Sagnier PP. The community-acquired pneumonia symptom questionnaire: a new, patient-based outcome measure to evaluate symptoms in patients with community-acquired pneumonia. Chest. 2002 Sep;122(3):920-9. doi: 10.1378/chest.122.3.920.
PubMed 12226033Lhopitallier L, Kronenberg A, Meuwly JY, Locatelli I, Mueller Y, Senn N, D'Acremont V, Boillat-Blanco N. Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomised trial. BMJ. 2021 Sep 21;374:n2132. doi: 10.1136/bmj.n2132.
PubMed 34548312Lhopitallier L, Kronenberg A, Meuwly JY, Locatelli I, Dubois J, Marti J, Mueller Y, Senn N, D'Acremont V, Boillat-Blanco N. Procalcitonin and lung ultrasonography point-of-care testing to decide on antibiotic prescription in patients with lower respiratory tract infection in primary care: protocol of a pragmatic cluster randomized trial. BMC Pulm Med. 2019 Aug 6;19(1):143. doi: 10.1186/s12890-019-0898-3.
PubMed 31387559Bessat C, Erard A, Roux A, Brahier T, Suttels V, Bingisser R, Schwendinger M, Bulaty T, Fournier Y, Della Santa V, Pfeil M, Schwab D, Leuppi JD, Geigy N, Steuer S, Roos F, Christ M, Sirova A, Atzl A, Napieralski F, Tagan D, Albricht WC, Hugli O, Boillat-Blanco N, Garcia E. Proficiency in lung ultrasound and perceived barriers to adoption among emergency physicians after a short pneumonia training programme: a multicentre observational study in Swiss emergency department. BMJ Open. 2026 Sep 8;16(9):e116508. doi: 10.1136/bmjopen-2026-116508.
PubMed 42711083Bessat C, Bingisser R, Schwendinger M, Bulaty T, Fournier Y, Della Santa V, Pfeil M, Schwab D, Leuppi JD, Geigy N, Steuer S, Roos F, Christ M, Sirova A, Espejo T, Riedel H, Atzl A, Napieralski F, Marti J, Cisco G, Foley RA, Schindler M, Hartley MA, Fayet A, Garcia E, Locatelli I, Albrich WC, Hugli O, Boillat-Blanco N; PLUS-IS-LESS study group. PLUS-IS-LESS project: Procalcitonin and Lung UltraSonography-based antibiotherapy in patients with Lower rESpiratory tract infection in Swiss Emergency Departments: study protocol for a pragmatic stepped-wedge cluster-randomized trial. Trials. 2024 Jan 25;25(1):86. doi: 10.1186/s13063-023-07795-y.
PubMed 38273319
Study at a glance
From the registry record, last updated by the sponsor on 24 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Procalcitonin and Lung Ultrasonography Based Antibiotherapy in Patients With Lower Respiratory Tract Infection in Swiss Emergency Departments: Pragmatic Stepped-wedge Cluster-randomized Trial
- ClinicalTrials.gov ID
- NCT05463406
- Acronym / sponsor ID
- PLUS-IS-LESS / PLUS-IS-LESS
- Conditions
- Lower Respiratory Tract Infection
- Keywords
- pneumonia, lung ultrasonography, procalcitonin, clinical prediction score, antimicrobial stewardship
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,407 participants (actual)
- Lead sponsor
- Dr Boillat-Blanco NoemieUniversity, hospital or other
- Collaborators
- Cantonal Hospital of St. Gallen, University Hospital, Basel, Switzerland, Kantonsspital Baden, Hôpital Intercantonal de la Broye, Payerne, Switzerland, Réseau Hospitalier Neuchâtelois, Hôpital Riviera-Chablais, Vaud-Valais, Luzerner Kantonsspital, Cantonal Hospital, Baselland, St. Claraspital AG
- Study start
- 5 Dec 2022 (actual)
- Primary completion
- 15 Mar 2025 (actual)
- Study completion
- 11 Jun 2025 (actual)
- First posted
- 19 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Acute respiratory infections are a common reason of attendance at emergency departments. It is also the main reason of unnecessary antibiotic prescription. Antibiotics save lives, but can also directly harm patients by causing antibiotic-associated adverse events. Antibiotic use is directly related to resistance, which is one of the major threats of our century. In addition, some microorganisms live in and on the human body and promote many aspects of our health. Antibiotic treatment can disturb those microorganisms and therefore have long-lasting negative effects on our health.
Unfortunately, it is difficult to differentiate between viral infections, which usually heal spontaneously, and bacterial pneumonia, which needs antibiotics treatment. This is one of the reasons of this over-prescribing of antibiotics.
This project aims to reduce widespread use of antibiotics in the emergency department through a new diagnostic strategy of bacterial pneumonia. This strategy includes sequential use of well-known techniques: a clinical score, lung ultrasound and finally a biomarker, procalcitonin. The latter tends to be higher in bacterial infections. The combination of these different tests improves the diagnostic process and allows improved use of targeted antibiotics, with the ultimate goal of better patient management.
The study will compare the antibiotic prescription rate and the clinical course of patients managed using this new diagnostic approach with those managed as usual. The project will also evaluate the acceptability and feasibility of this strategy and its cost-effectiveness. These two aspects are essential for a wider implementation of this innovative diagnostic approach and decrease antibiotic resistance.
Detailed description
Background Community-acquired lower respiratory tract infections (LRTI) are one of the most common motivations for emergency department (ED) consultations and stands as the leading cause of inappropriate antibiotic prescription. Besides the side effects, antibiotic overuse alters the microbiome and generates antibiotic resistance. When assessing patients with LRTIs, the challenge for ED physicians is to identify those with community-acquired pneumonia (CAP) of bacterial origin, who will most likely benefit from antibiotics. The low diagnostic accuracy of existing tools, as well as the poor adherence of clinicians to test guidance are leading causes of inappropriate antibiotic use.
Several diagnostic tests can assist in identifying patients with LRTI who require antibiotics. Clinical prediction score can refine the probability of CAP. Lung ultrasound (LUS) has a better diagnostic performance than chest X-ray, the historic reference imaging modality to consolidation in ED. LUS is performed quickly at the bedside without radiation. Procalcitonin (PCT) is a host inflammatory biomarker which tends to be higher in bacterial infections. PCT can be used safely to guide antibiotics use, while its impact on prescription is controversial. None of these tools on its own is sufficient to optimize antibiotic prescription, while a combined approach could better guide clinicians.
Rationale The investigators propose to evaluate the use of a decision support tool to guide antibiotics use in the ED as the summative value of LUS with PCT remains unknown in this setting.
Pragmatic stepped-wedge cluster-randomized controlled clinical trial investigating a new algorithm combining a clinical score, LUS and PCT results (The PLUS algorithm) for the management of LRTIs among adults in EDs. The unit of randomization will be the ED.
Primary safety objective To demonstrate non-inferiority of the intervention in terms of clinical failure by day 28.
Co-primary efficacy objective To show a 15% reduction in the proportion of patients with LRTIs prescribed an antibiotic by day 28 in the intervention group compared with the usual care group.
Secondary objectives
- To compare the quality of life (bothersomeness of CAP-related symptoms) on day 7, day 28 and day 90 between patients in the intervention and control groups.
- To evaluate the acceptability and feasibility of the intervention through the identification of barriers and facilitators in patients and physicians.
- To assess the incremental cost-effectiveness of the intervention as compared to usual care using a within-trial (short-term), and a model-based (long-term) economic evaluation.
- To develop an advanced automatic LUS image analysis method using machine learning to assist in LUS diagnosis and risk stratification.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Pragmatic stepped-wedge cluster-randomized controlled clinical trial investigating a new algorithm combining a clinical score, LUS and PCT results (The PLUS algorithm) for the management of LRTIs among adults in EDs. The unit of randomization will be the ED.
| Arm | Type | Receives |
|---|---|---|
| The PLUS algorithm | Experimental | Other: The PLUS algorithmThe PLUS clinical management algorithm: EDs having switched to the intervention period (intervention group) will manage their patients using the PLUS algorithm. The PLUS algorithm starts with a validated pneumonia clinical prediction score (score of Van Vugt), followed by LUS. In case of positive results of any of these tests, PCT is measured to identify patients who will most likely benefit from antibiotics. A validated clinical severity score will ensure the safety of the intervention in those with discordant results (LUS consolidation and low PCT). |
| Usual care | Other | Other: Usual careUsual care: management as usual |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Signed informed consent
- Patients aged 18 years or more
- Acute LRTI (acute illness, less than 21 days, with at least one lower respiratory tract symptom, i.e. cough, sputum, dyspnea, chest pain and no alternative explanation)
- At least one of the following clinical criteria:
Key exclusion criteria (8 listed)
- Previous receipt of a quinolone, macrolide or ceftriaxone or, of more than one dose of any other antibiotic within 72h prior to enrolment (excepted prophylactic antibiotics or antibiotics given for urinary tract infection)
- Previous hospital stay in the last 14 days
- Cystic fibrosis
- Severe COPD (≥GOLD 3 or if not available, as a proxy: exacerbation treated with antibiotics during the last 6 months)
- Severe immunodeficiency (drug-induced neutropenia with <500 neutrophils/mm3, HIV infection with CD4<200 cells/mm3, solid organ or bone marrow transplant recipient, prednisone ≥ 20mg/day for >28 days)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| The PLUS algorithmCombination of a clinical prediction score and LUS, and if needed PCT measurement | Other | The PLUS algorithm |
| Usual careManagement as usual | Other | Usual care |
Primary outcome
Safety outcome
Time frame: Day 28
Proportion of patients with clinical failure (defined as a composite of any of the following: death or secondary ICU admission or secondary admission to hospital or hospital re-admission after index hospital discharge or complications due to the LRTI [empyema, lung abscess])
Efficacy outcome
Time frame: Day 28
Proportion of patients prescribed an antibiotic in each intervention group between enrolment and day 28
9 secondary outcomes
Quality of life measured with the community-acquired pneumonia symptom questionnaire
Time frame: Day 7, Day 28, Day 90
Hospitalisation
Time frame: Day 0 to Day 90
Efficacy endpoint
Time frame: Day 90
Antibiotic side effects and C. difficile infection
Time frame: Day 0 to Day 28
Emergency department stay
Time frame: Day 0 to Day 28
Qualitative evaluation
Time frame: Day 90
Machine learning of Lung ultrasonography (LUS) images and videos
Time frame: Day 90
Economic evaluation
Time frame: Day 90
Clinical gestalt
Time frame: Day 0
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Apr 2026.
- Results publication: PubMed 12226033Lamping DL, Schroter S, Marquis P, Marrel A, Duprat-Lomon I, Sagnier PP. The community-acquired pneumonia symptom questionnaire: a new, patient-based outcome measure to evaluate symptoms in patients with community-acquired pneumonia. Chest. 2002 Sep;122(3):920-9. doi: 10.1378/chest.122.3.920.
- Results publication: PubMed 34548312Lhopitallier L, Kronenberg A, Meuwly JY, Locatelli I, Mueller Y, Senn N, D'Acremont V, Boillat-Blanco N. Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomised trial. BMJ. 2021 Sep 21;374:n2132. doi: 10.1136/bmj.n2132.
- Results publication: PubMed 31387559Lhopitallier L, Kronenberg A, Meuwly JY, Locatelli I, Dubois J, Marti J, Mueller Y, Senn N, D'Acremont V, Boillat-Blanco N. Procalcitonin and lung ultrasonography point-of-care testing to decide on antibiotic prescription in patients with lower respiratory tract infection in primary care: protocol of a pragmatic cluster randomized trial. BMC Pulm Med. 2019 Aug 6;19(1):143. doi: 10.1186/s12890-019-0898-3.
- Derived from this study: PubMed 42711083Bessat C, Erard A, Roux A, Brahier T, Suttels V, Bingisser R, Schwendinger M, Bulaty T, Fournier Y, Della Santa V, Pfeil M, Schwab D, Leuppi JD, Geigy N, Steuer S, Roos F, Christ M, Sirova A, Atzl A, Napieralski F, Tagan D, Albricht WC, Hugli O, Boillat-Blanco N, Garcia E. Proficiency in lung ultrasound and perceived barriers to adoption among emergency physicians after a short pneumonia training programme: a multicentre observational study in Swiss emergency department. BMJ Open. 2026 Sep 8;16(9):e116508. doi: 10.1136/bmjopen-2026-116508.
- Derived from this study: PubMed 38273319Bessat C, Bingisser R, Schwendinger M, Bulaty T, Fournier Y, Della Santa V, Pfeil M, Schwab D, Leuppi JD, Geigy N, Steuer S, Roos F, Christ M, Sirova A, Espejo T, Riedel H, Atzl A, Napieralski F, Marti J, Cisco G, Foley RA, Schindler M, Hartley MA, Fayet A, Garcia E, Locatelli I, Albrich WC, Hugli O, Boillat-Blanco N; PLUS-IS-LESS study group. PLUS-IS-LESS project: Procalcitonin and Lung UltraSonography-based antibiotherapy in patients with Lower rESpiratory tract infection in Swiss Emergency Departments: study protocol for a pragmatic stepped-wedge cluster-randomized trial. Trials. 2024 Jan 25;25(1):86. doi: 10.1186/s13063-023-07795-y.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
9 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing The PLUS algorithm in people with Lower Respiratory Tract Infection, run by Dr Boillat-Blanco Noemie at 9 sites in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 9 sites in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Safety outcome (time frame: Day 28). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05463406, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2026.