Last updated on June 2019

Community-Acquired Pneumonia : Evaluation of Corticosteroids

Are you eligible to participate in this study?

You may be eligible for this study if you meet the following criteria:

  • Conditions: Community Acquired Pneumonia
  • Age: Between 18 - 100 Years
  • Gender: Male or Female

Inclusion Criteria:

  • Age 18 years
  • Patients affiliated to social security scheme
  • Admission to an Intensive Care Unit (ICU) or intermediate care unit participating to the trial
  • Diagnosis of Community- Acquired Pneumonia (CAP) suggested by at least two of the following: cough, purulent sputum, chest pain and dyspnea
  • Focal shadowing/infiltrate on chest X-ray or CT-scan
  • Diagnosis of Community- Acquired Pneumonia (CAP) during the 48 hours post-hospital admission
  • Study drug infusion initiated no longer than 24 hours post first severity criterion
  • Severity defined by at least one of the following:
  • Pneumonia Severity Index (PSI) > 130 (Fine class V)
  • Patient placed on mechanical ventilation (invasive or not) for acute respiratory failure, with a PEEP level of 5 cm of water or more
  • Patient treated by high-flow oxygen therapy with a FiO2 of 50% or more and a P/F ratio less than 300
  • Patient treated by oxygen therapy with a partial rebreathing-mask with a reservoir bag, provided that the PaO2 is less than (cf. table):

Oxygen flow (L/min) 6 7 8 9 10 or more PaO2 (mmHg) less than 180 210 240 270 300

  • Patient already treated by antibiotics (at least one dose since admission to hospital)
  • Informed consent signed by the patient, its relatives or emergency procedure

Exclusion Criteria:

  • Patient treated by vasopressors for septic shock at the time of inclusion
  • Clinical history suggesting of aspiration of gastric content
  • Patient treated by invasive mechanical ventilation within 14 days before current hospital admission
  • Patient treated by antibiotics for a respiratory infection for more than seven days at the admission to the hospital (except if a pathogen resistant to this antibiotics is isolated)
  • History of cystic fibrosis
  • Post-obstructive pneumonia
  • Patients in which rapid PCR-test is positive for flu
  • Active tuberculosis or fungal infection
  • Active viral hepatitis or active infection with herpes viruses
  • Myelosuppression
  • Decision of withholding mechanical ventilation or endotracheal intubation
  • Hypersensitivity to corticosteroids
  • Patient needing anti-inflammatory corticosteroids or substitutive hydrocortisone for any reason
  • Patients under treatment by more than 15 mg/d of prednisone (or equivalent) for more than 30 days
  • Patient already enrolled in another drug trial with mortality as an end-point. If the patient is already participating in another therapeutic trial with a different endpoint, the investigator must verify that inclusion in CAPE COD can not prejudice it.
  • Pregnant or breastfeeding woman
  • Patient on judicial protection

Recruitment Status: Open

Brief Description Eligibility Contact Research Team

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