Use of MULTIplex PCR, procalcitonin and the appearance of sputum to reduce the duration of antibiotic therapy during severe COPD EXAcerbation: a trial controlled, randomized, open, in parallel groups, multicenter

Other illness

• Antibiotic therapy formally indicated for a suspected or documented extra-respiratory infection
• Congenital or acquired immunosuppression (congenital immune deficiency, progressive high-grade hematological malignancy, immunosuppressive drugs in the last 30 days including cytotoxic anti-cancer chemotherapy and anti-rejection drugs, corticosteroid therapy ≥ 20 mg/d of prednisone equivalent for at least 14 days, neutropenia, HIV with unknown or known CD4<200/µL in the last 6 months)

Other

• Delay between admission to hospital and admission to ICU/ICU greater than 3 days
• Current pregnancy.
• Tracheotomy
• Bronchial dilatation/cystic fibrosis
• Moribund patient (imminent death)
• Patient deprived of liberty and/or protected by law
• Patient already included in MULTI-EXA
• Patient already included in a type 1 interventional clinical study (RIPH1) relating to antibiotics

• Age ≥ 18 years old
• Post-smoking COPD confirmed according to GOLD 2020, whatever the stage (I-IV)
• Acute exacerbation (defined by the appearance or increase of one or more of the usual signs/symptoms of COPD) with acute respiratory failure requiring admission to the ICU/Resuscitation and mechanical ventilation (invasive or non-invasive or nasal oxygen therapy high flow rate with FiO2 ≥ 50%)
• Consent (patient, relative or inclusion in emergency situation)
• Affiliation to a social security scheme.