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Hospital-acquired PneumoniaSHARPNCT04153682

Trial on a Strategy Combining Rapid Diagnostic Testing and Antimicrobial Stewardship to Improve Antibiotic Use in Patients With Hospital-acquired Pneumonia.

A study testing Rapid Diagnostic Testing and Antimicrobial stewardship in people with Hospital-acquired Pneumonia, run by Assistance Publique - Hôpitaux de Paris at 8 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Hospital-Acquired Pneumonia (HAP) is the second most frequent hospital-acquired infection in the US and Europe and accounts for a large proportion of antibiotics prescribed in hospitals. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hospital-acquired Pneumonia
What is being tested?
Rapid Diagnostic Testing and Antimicrobial stewardship
Could I receive a placebo?
No, everyone receives an active treatment
How many people
116 participants
Where
8 sitesFrance
Study dates
21 Feb 2020to 31 Aug 2023
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

  • Any patient hospitalized for ≥ 48 hours
  • aged 18 years or older
  • not mechanically-ventilated at time of onset of pneumonia symptoms
  • Dated and signed inform consent - written informed consent of relative (trusted person, close family) in case of emergency procedure, by default emergency inclusion notified in medical file and pursuance consent sought
  • Affiliation with a social security scheme
  • Criteria of pneumonia:
  • New lung infiltrate on a chest-x ray plus
  • Evidence that the infiltrate is of an infectious origin, i.e. new onset of fever (> 38.5°C) and/or purulent sputum and/or leukocytosis and/or decline in oxygenation

Who cannot join

  • Patients with severe chronic bronchitis structural changes: very severe COPD (Global initiative for chronic Obstructive Lung Disease GOLD 4), cystic fibrosis
  • Radiological evidence of thoracic empyema, pulmonary abcess
  • Patient life expectancy < 90 days

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

France8 sites
  • Hôpitaux Universitaires Henri Mondor

    Créteil, 94010

  • CHRU Nancy

    Nancy, 54511

  • Hôpitaux Universitaires Paris Centre (Cochin) - service Médecine Intensive - Réanimation

    Paris, 75006

  • Groupe Hospitalier Paris Saint Joseph

    Paris, 75014

  • Hôpitaux Universitaires Paris Centre-Site Cochin

    Paris, 75014

  • Hôpitaux Universitaires Paris Nord Val de Seine-Site Bichat (SMIT)

    Paris, 75018

  • Hôpitaux Universitaires Paris Nord Val de Seine - EPRI (Bichat)

    Paris

  • Hôpitaux Universitaires Paris Nord Val de Seine - MIR (Bichat)

    Paris

Other trials in France

About this study

Official title: Impact of a Strategy Combining the Rapid Polymerase Chain Reaction Platform FilmArray® and the Intervention of an Antimicrobial Stewardship Team in Hospital-acquired Pneumonia : a Randomized Controlled Trial.

Hospital-Acquired Pneumonia (HAP) is the second most frequent hospital-acquired infection in the US and Europe and accounts for a large proportion of antibiotics prescribed in hospitals. Conventional methods to identify causative microorganisms (virus, bacteria) are time-consuming and sometimes inaccurate, leading to inadequate treatment in a large proportion of HAP patients.

The FILMARRAY® Pneumonia Panel (FA-PP, bioMérieux) is an automated diagnostic device, allowing detection of multiple pathogens and resistance markers in one hour. Strategies combining rapid diagnostic testing and intervention of specialists in infectious diseases (i.e. antimicrobial stewardship -AMS - experts) showed significant synergistic impact on antibiotic use, mortality and costs in bloodstream infections.

Read more

The trial hypothesis is that a strategy combining antimicrobial stewardship and FA-PP improves quality of care in HAP patients, as compared to antimicrobial stewardship alone.

The trial will include patients hospitalized for ≥ 48 hours, aged 18 years or older, who have criteria of pneumonia: new lung infiltrate on a chest-x ray, plus evidence that the infiltrate is of an infectious origin (i.e. new onset of fever and/or purulent sputum and/or leukocytosis and/or decline in oxygenation).

After informed consent, participants will be randomly allocated to either the intervention or the control arm.

In the control arm, management of HAP patients will include clinical examination and conventional microbiological tests. Antibiotic choice will be discussed between AMS experts and the physician in charge of the patient.

In the intervention arm, in addition to the procedures above, the strategy will include rapid testing using the FA-PP on a respiratory specimen, obtained by either invasive or non-invasive sampling. No additional invasive procedures will be required for the study, and FA-PP will be performed on samples collected as part as routine care.

Investigators will visit the patient at inclusion, on day 3 and on day 30 (or at hospital discharge) to collect data on comorbidities, clinical outcomes, results of microbiological tests and antibiotics. At the end of follow-up, we will compare the number of days on broad-spectrum antibiotics, the incidence of negative outcomes, the length of stay and costs in the two arms.

The use of the FA-PP is expected to prompt early adjustment of antibiotic therapy, improve outcomes, decrease length of stay, and to reduce the use of broad-spectrum antibiotics. The antibiotic saving may reduce the selection pressure, incidence of colonization with multidrug-resistant bacteria and incidence of hospital-acquired superinfections, both at an individual and hospital level. Moreover, this trial relies on the intervention of multidisciplinary AMS teams that are currently being implemented in many health facilities. Their transversal position offers opportunities for recruitment of patients from a wide range of medical and surgical departments. This project evaluates the feasibility of clinical trials based on the intervention of these teams, and will provide a high level of evidence regarding their impact on the prognosis of patients, appropriate use of antibiotics, and antimicrobial resistance.

Being tested
Rapid Diagnostic Testing, Antimicrobial stewardship
Keywords
Antimicrobial stewardship, hospital-acquired pneumonia, syndromic approach, rapid diagnostic testing
Medical subject headings
Healthcare-Associated Pneumonia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Rapid Diagnostic TestingDiagnostic test

    Also called Filmarray® Pneumonia Panel (FA-PP)

    Automated microbiological diagnostic device based on multiplex PCR analysis, allowing detection of multiple pathogens and resistance markers in one hour from invasive and non-invasive respiratory samples

  • Antimicrobial stewardshipDiagnostic test

    Also called AMS

    After clinical examination, routine biological tests will be performed. This includes blood culture, direct examination and culture of invasive or noninvasive respiratory samples, urinary antigen tests for Legionella and Pneumococcus, Influenza PCR on nasopharyngeal swabs (during the influenza season).

Study groups in NCT04153682
Study groupRoleWhat they receive
Antimicrobial stewardship (= AMS)Active comparatorManagement of HAP according to current practice, including intervention of the AMS team.
Receives: Diagnostic Test: Antimicrobial stewardship
Antimicrobial Stewardship + Rapid Diagnostic TestingExperimentalManagement of HAP including rapid diagnostic testing (FA-PP) and intervention of the AMS team.
Receives: Diagnostic Test: Rapid Diagnostic Testing; Diagnostic Test: Antimicrobial stewardship

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of days on broad-spectrum antibiotics at day 30 or end-of follow-up for 100 patients-days

    Number of days that a patient is on an antibiotic, regardless of dose. The list of broad-spectrum antibiotics was defined according to previous literature data.

    Measured: Day 30 or hospital discharge (plus or minus 4 days)

Secondary outcomes (7)
  1. Overall antibiotic use

    Number of days on antibiotics per 100 patient-days

    Measured: Day 30 or hospital discharge (plus or minus 4 days)

  2. Duration of antibiotics for the HAP episode

    Number of days on any antibiotic for the HAP episode

    Measured: up to 30 days

  3. Mortality

    Measured: up to 30 days

  4. In-hospital length of stay

    Number of days between admission and discharge

    Measured: up to 24 weeks

  5. Incidence of Clostridium difficile colitis

    Number of patients with documented Clostridium difficile colitis per 100 patient-days.

    Clostridium difficile colitis is defined by clinical evidence of colitis (unexplained and new-onset ≥3 unformed stools) and positive microbiological test relying on the multistep algorithm routinely used in each investigating center and compliant with national and international standards.

    Measured: Day 30 or hospital discharge (plus or minus 4 days)

  6. Medical direct costs

    Costs of the FILMARRAY® Pneumonia panel (labor and consumables), Antibiotic costs, Total admission costs

    Measured: Day 30 or hospital discharge (plus or minus 4 days)

  7. Analytical performances of the FILMARRAY® Pneumonia panel compared to conventional methods

    Number of discrepancies on Micro-organism identification and Antibiotic resistance

    Measured: End of the study

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Nov 2019
  2. Study start21 Feb 2020
  3. Primary completion31 Aug 2023
  4. Study completion31 Aug 2023

Resources

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
Parallel groups
Masking
None (open label)
Enrolment
116 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04153682
Sponsor's protocol ID
APHP180391
Acronym
SHARP
Status last verified
Oct 2025
First submitted
2 Sep 2019
Last updated
12 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O'Grady NP, Bartlett JG, Carratala J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016 Sep 1;63(5):e61-e111. doi: 10.1093/cid/ciw353. Epub 2016 Jul 14.

    PubMed 27418577
  • Messika J, Stoclin A, Bouvard E, Fulgencio JP, Ridel C, Muresan IP, Boffa JJ, Bachmeyer C, Denis M, Gounant V, Esteso A, Loi V, Verdet C, Prigent H, Parrot A, Fartoukh M. The Challenging Diagnosis of Non-Community-Acquired Pneumonia in Non-Mechanically Ventilated Subjects: Value of Microbiological Investigation. Respir Care. 2016 Feb;61(2):225-34. doi: 10.4187/respcare.04143. Epub 2015 Dec 8.

    PubMed 26647452
  • Gadsby NJ, Russell CD, McHugh MP, Mark H, Conway Morris A, Laurenson IF, Hill AT, Templeton KE. Comprehensive Molecular Testing for Respiratory Pathogens in Community-Acquired Pneumonia. Clin Infect Dis. 2016 Apr 1;62(7):817-823. doi: 10.1093/cid/civ1214. Epub 2016 Jan 7.

    PubMed 26747825
  • Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, Gould IM, Ramsay CR, Michie S. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2017 Feb 9;2(2):CD003543. doi: 10.1002/14651858.CD003543.pub4.

    PubMed 28178770
  • Bookstaver PB, Nimmich EB, Smith TJ 3rd, Justo JA, Kohn J, Hammer KL, Troficanto C, Albrecht HA, Al-Hasan MN. Cumulative Effect of an Antimicrobial Stewardship and Rapid Diagnostic Testing Bundle on Early Streamlining of Antimicrobial Therapy in Gram-Negative Bloodstream Infections. Antimicrob Agents Chemother. 2017 Aug 24;61(9):e00189-17. doi: 10.1128/AAC.00189-17. Print 2017 Sep.

    PubMed 28630187
  • Kerneis S, Canoui E, Deconinck L, Dlela M, Valade S, Lortat-Jacob B, Ollivier C, Kardas-Sloma L, Charpentier J, Loubinoux J, Pilmis B, Mizrahi A, Lepeule R, Decousser JW, Bercot B, Poyart C, Lescure FX, Montravers P, Azoulay E, Durand-Zaleski I, Abdoul H, Timsit JF, Armand-Lefevre L; SHARP study group; SHARP study group. PCR-based syndromic tests for antibiotic stewardship in non-ventilated patients with hospital-acquired pneumonia: a multicentre randomized controlled trial. JAC Antimicrob Resist. 2026 Jul 30;8(4):dlag154. doi: 10.1093/jacamr/dlag154. eCollection 2026 Aug.

    PubMed 42534393
  • Kerneis S, Visseaux B, Armand-Lefevre L, Timsit JF. Molecular diagnostic methods for pneumonia: how can they be applied in practice? Curr Opin Infect Dis. 2021 Apr 1;34(2):118-125. doi: 10.1097/QCO.0000000000000713.

    PubMed 33395094

Questions about this trial

What is this clinical trial studying?

A study testing Rapid Diagnostic Testing and Antimicrobial stewardship in people with Hospital-acquired Pneumonia, run by Assistance Publique - Hôpitaux de Paris at 8 sites in France.

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 3 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 12 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in France. 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?

Number of days on broad-spectrum antibiotics at day 30 or end-of follow-up for 100 patients-days (time frame: Day 30 or hospital discharge (plus or minus 4 days)). 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 NCT04153682, which also lists 7 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 12 Aug 2026.

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