Early Discontinuation of Antibiotic Therapy in Elderly Patients Hospitalized for a Viral Infection

Summary

Among winter respiratory viruses, influenza is the most common and therefore responsible for the highest mortality, but parainfluenza and RSV viruses have an even higher risk of mortality (1.6 to 1.9 times), this toll being paid mainly by the elderly and co-morbid population. Futhermore, SARS-Cov2 will probably become endemic and/or epidemic with the same targets of fragile patients. These viral infections are serious, however a bacterial co-infection worsens the prognosis even more: excess risk of mortality = 2.6, 95% CI \[1.9-3.7\].

Although rare, these co-infections are the subject of a prescription of antibiotics in more than 50% of influenza infections or other serious viral infections. Mainly due to this excess risk of mortality associated with the difficulty of diagnosing these co-infections.

Proper antibiotic use requires preventing this misuse and its harmful consequences in the short and long term at all costs. It is therefore imperative to have solid (grade A) evidence showing that antibiotic therapy in viral infections is not only futile but also potentially harmful.

Conditions

• PCR Multiplex
• Elderly
• Antibiotics Overuse
• Viral Infections

Interventions

DRUG

antibiotic withdrawal

stop antibiotics on viral or negative results

DRUG

Antibiotics

standard of care Antibiotics are : Amoxicilline-acide clavulanique : 1g x3/j, 7j or Ceftriaxone : 1g/j, 7j or Pipéracilline-Tazobactam : 4g x3/j, 7j or Pristinamycine : 1g x 3/j, 7j

Sponsors & Collaborators

• University Hospital, Rouen

  collaborator OTHER

• Centre Hospitalier de Beauvais

  collaborator OTHER

• University Hospital, Caen

  collaborator OTHER

• Hôpital Les Bateliers, CHU de Lille

  collaborator UNKNOWN

• Centre Hospitalier Roubaix

  collaborator UNKNOWN

• CH SOISSONS

  collaborator UNKNOWN

• Tourcoing Hospital

  collaborator OTHER

• Centre Hospitalier Universitaire, Amiens

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-02-14

Primary Completion

2027-03-31

Completion

2027-06-30

Countries

• France

Study Locations