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Pneumonia ChildhoodLUSCAPNCT06921993

Lung Ultrasound for Guiding Antibiotic Use in Pediatric Pneumonia

A study testing LUNG ULTRASOUND in people with Pneumonia Childhood and Pneumonia, run by Meyer Children's Hospital IRCCS at 18 sites in 3 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Pneumonia is a major cause of illness and death in children, with an annual incidence of about 3.3 per 1,000 in those under five years old, many requiring hospitalization. The diagnosis is challenging due to the absence of a universally accepted gold standard, leading to variability in emergency settings. Read more about this study

Who is it for?
Ages 3 to 10 years
Conditions the study is for
Pneumonia Childhood, Pneumonia, Lung Ultrasound
What is being tested?
LUNG ULTRASOUND
Could I receive a placebo?
No, everyone receives an active treatment
How many people
659 participants
Where
18 sitesin 3 countries
Study dates
24 Apr 2025to 30 Jun 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

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 3 to 10 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Well-appearing, clinically stable patients aged 3 to 10 years, presenting to the pediatric ED with suspected pneumonia based on a combination of signs and symptoms suggestive of lower respiratory tract infection (LRTI), including:
  • Respiratory Symptoms: Cough, Tachypnea, Dyspnea (Increased work of breathing), Abnormal findings on auscultation.
  • Systemic Symptoms: Fever, Hypoxia, Decreased appetite.

Who cannot join

  • Neonates and children up to 3 years of age, and children older than 10 years
  • Children aged 3 to 10 years with any of the following factors:
  • Recent hospitalization (within the past 14 days)
  • Prior CXR or any other chest imaging (e.g. CT scan)
  • Ongoing antibiotic therapy
  • Hemodynamic instability
Show all 9Show fewer
  • Respiratory failure or severe respiratory distress and/or hypoxemia, requiring urgent assessment for conditions such as pneumothorax, hemothorax, or other emergency respiratory conditions
  • History of aspiration or ab ingestis pneumonia
  • Underlying medical conditions predisposing to severe or recurrent pneumonia, including immunodeficiency, chronic corticosteroid use, chronic lung disease, malignancy, sickle cell disease, congenital heart disease, tracheostomy, and neuromuscular disorders affecting respiration

Trial locations and contacts

18 sites in 3 countries. Contact the study team or a site near you to ask about taking part.

Martina Cecchetti, MD contact

luscaptrial@gmail.com

18 sites in 3 countries

Italy13 sites, 11 recruiting
  • ASST Papa Giovanni XXIII

    Bergamo

    Recruiting
  • IRCCS Sant'Orsola

    Bologna

    Recruiting
  • Ospedale dei Bambini

    Brescia

    Not yet recruiting
  • Meyer Children's Hospital IRCCS

    Florence, Italy, 50139

    Niccolò Parri, MD, +390555662634, niccolo.parri@meyer.it

    Martina Cecchetti, MD, luscaptrial@gmail.com

    Recruiting
  • IRCCS Istituto Giannina Gaslini

    Genova

    Recruiting
  • IRCCS Fondazione Cà Granda - Policlinico

    Milan

    Active, not recruiting
  • Ospedale Pediatrico Santobono - Pausillipon

    Naples

    Not yet recruiting
  • Ospedale Maggiore della Carità

    Novara

    Recruiting
  • Azienda Ospedale Università di Padova

    Padova

    Recruiting
  • IRCCS Gemelli

    Roma

    Active, not recruiting
  • Ospedale Pediatrico Bambino Gesù

    Roma

    Not yet recruiting
  • Ospedale Infantile Regina Margherita

    Torino

    Not yet recruiting
  • Ospedale Burlo Garofolo

    Trieste

    Not yet recruiting

Other trials in Italy

United States4 sites, 2 recruiting
  • University of Wisconsin

    Madison, Wisconsin, 53706

    Active, not recruiting
  • Yale New Haven Children's Hospital

    New Haven, Connecticut, 06511

    Recruiting
  • Columbia University

    New York, New York, 10027

    Not yet recruiting
  • Rady Childrens/UCSD

    San Diego, California, 92123

    Active, not recruiting

Other trials in United States

Israel1 site, 1 recruiting
  • Schneider Children's Hospital

    Petah Tikva, 49202

    Not yet recruiting

Other trials in Israel

About this study

Official title: Lung Ultrasound for Antibiotic Stewardship in Community-Acquired Pneumonia: A Randomized Clinical Trial

Pneumonia is a major cause of illness and death in children, with an annual incidence of about 3.3 per 1,000 in those under five years old, many requiring hospitalization. The diagnosis is challenging due to the absence of a universally accepted gold standard, leading to variability in emergency settings. Current guidelines recommend diagnosis based on history and physical examination, which do not reliably differentiate pneumonia from other respiratory infections or identify whether it is bacterial or viral in nature. This uncertainty can lead to the unnecessary use of antibiotics.

Commonly used chest X-rays have limitations such as low sensitivity, moderate interobserver reliability, and the inability to distinguish bacterial from viral pneumonia. In contrast, lung ultrasound has shown high sensitivity and specificity for diagnosing pneumonia in children. However, lung ultrasound also cannot reliably distinguish between bacterial and viral causes and might lead to increased antibiotic prescriptions by detecting minor lung consolidations not seen on chest X-rays. Despite these issues, lung ultrasound is widely used in pediatric pulmonary assessment.

Read more

The primary objective of the study is to determine if using lung ultrasound for diagnosing pneumonia in children can reduce antibiotic prescriptions compared to the standard care approach-which mainly relies on clinical diagnosis (often supplemented by chest X-ray and blood tests in selected cases). The secondary objective is to assess how frequently lung ultrasound impacts management decisions during a single clinical visit, beyond the information provided by history and physical examination. The third objective is to compare the diagnostic accuracy of lung ultrasound-supported diagnosis with existing diagnostic methods.

The study hypothesizes that lung ultrasound results can act as a decision modifier, similar to other clinical tools and examination findings. However, a lack of consensus on specific lung ultrasound parameters and their clinical correlations contributes to variability in managing suspected pneumonia, potentially leading to antibiotic overuse.

Eligible participants are children aged three to ten years who are in good general condition and clinically stable, presenting with signs and symptoms of lower respiratory tract infection indicative of pneumonia. Exclusion criteria include children outside the specified age range, those recently hospitalized, those who have undergone prior chest imaging, those already on antibiotic therapy, those with severe clinical instability, and those with underlying conditions predisposing them to severe or recurrent pneumonia. These criteria help ensure that the study population represents general pediatric community-acquired pneumonia cases, avoiding biases from high-risk patients.

The ultimate goal of this study is to provide evidence on whether lung ultrasound can serve as a reliable tool to guide antibiotic prescriptions, thereby reducing unnecessary antibiotic use in the management of pediatric pneumonia.

Read the detailed description

This prospective, randomized, multicenter clinical trial aims to determine whether using lung ultrasound (LUS) in children aged 3-10 years with suspected pneumonia can reduce the prescription of antibiotics, compared to the standard of care (clinical diagnosis, with optional chest X-ray and blood tests). A second objective is to assess how often LUS findings alter clinical decision-making beyond history and physical examination alone, while a third objective compares the diagnostic accuracy of an LUS-based approach to current pathways.

Study Design and Intervention

Children presenting with signs and symptoms of lower respiratory tract infection (e.g., cough, tachypnea, fever) who are clinically stable and in good general condition are eligible.

Exclusion criteria include recent hospitalization, prior imaging, ongoing antibiotic therapy, severe respiratory distress, and underlying conditions predisposing to complicated pneumonia.

Participants are randomized to an experimental group, where LUS is performed immediately after clinical assessment, or a control group, which follows standard care.

Clinicians in both groups may request a chest X-ray if warranted, and the reasons for imaging are documented.

All participants receive routine evaluations, and interventions (e.g., blood tests, antibiotic decisions) remain at the discretion of the treating physician.

Outcomes

Primary Outcome: Reduction in antibiotic prescriptions in the LUS group versus the control group.

Secondary Outcomes:

The rate at which LUS modifies diagnoses and clinical management compared to assessments using only history and physical examination.

Differences in emergency department (ED) length of stay, hospital admission rates, and unscheduled healthcare visits within one week.

Overall diagnostic accuracy of LUS-supported diagnosis compared to standard methods.

Additional Measures:

An expert panel (pediatric radiologist, pulmonologist, and emergency physician) will determine a consensus final diagnosis after reviewing clinical data.

Data Management and Follow-Up

Each patient's care pathway is documented using a 1-5 Likert scale capturing the likelihood of pneumonia and willingness to prescribe antibiotics at various decision points (clinical exam, optional LUS, and optional chest X-ray).

A follow-up call occurs 5-7 days post-discharge to track clinical progress and any subsequent antibiotic use.

Data are recorded and stored in REDCap, with pseudonymized patient identifiers.

No significant risks are anticipated. The benefits include potentially improving diagnostic accuracy and reducing unnecessary antibiotic prescriptions.

Ultimately, this study seeks to clarify whether incorporating LUS into standard pediatric pneumonia assessment can enhance decision-making, leading to more judicious antibiotic use without compromising patient care.

Being tested
LUNG ULTRASOUND
Keywords
Pneumonia, Children, Pediatrics, Lung ultrasound, point-of-care ultrasound
Medical subject headings
Pneumonia

What participants receive

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

  • LUNG ULTRASOUNDDiagnostic test

    All subjects randomly assigned to the investigational arm will undergo lung ultrasound (LUS) .

    Ultrasound still images and ultrasound clips will be acquired according to the study protocol. Detailed methodology of the ultrasound examination and parameters is provided as appendix to the study protocol

Study groups in NCT06921993
Study groupRoleWhat they receive
Control group - standard of careNo interventionAll subjects randomly assigned to the control arm will undergo a complete patient history and clinical assessment (the reference standard). If there is clinical uncertainty, the enrolling physician has the option to perform other test such as CXR or blood test.
Experimental Group - Lung Ultrasound (LUS)ExperimentalAll subjects randomly assigned to the investigational arm will undergo lung ultrasound (LUS) . The LUS will be performed immediately following a thorough patient history and complete clinical assessment. Ultrasound still images and ultrasound clips will be acquired according to the study protocol. Detailed methodology of the ultrasound examination and parameters is provided as appendix to the study protocol
Receives: Diagnostic Test: LUNG ULTRASOUND

What is being measured

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

  1. Percentage of participants with antibiotic use

    A chart review and follow up phone call made at 1 week (range 5-7 days) to assess whether or not the subject was started on antibiotics during the index ED visit or at a later healthcare visit. The primary objective of this study is to determine if it is possible for LUS to reduce antibiotic prescription when evaluating patients with possible pneumonia. Specifically, an overall reduction of antibiotic when LUS is used as adjunct tool in the

    Measured: 7 days

Secondary outcomes (2)
  1. Percentage of participants who had hospital admission

    Chart review and follow up phone call made at 1 week (range 5-7 days) to assess whether or not the subject was admitted during the index ED visit or at a later healthcare visit.

    Measured: 7 days

  2. Percentage of participants with antibiotic use

    A chart review and follow up phone call made at 1 week (range 5-7 days) to assess whether or not the subject was started on antibiotics during the index ED visit or at a later healthcare visit. The primary objective of this study is to determine if it is possible for LUS to reduce antibiotic prescription when evaluating patients with possible pneumonia. Specifically, an overall reduction of antibiotic when LUS is used as adjunct tool in the assessment.

    Measured: 7 days

Timeline

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

  1. First posted10 Apr 2025
  2. Study start24 Apr 2025
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion30 Jun 2028 (estimated)

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
Model description
Randomized diagnostic clinical trial
Masking
None (open label)
Enrolment
659 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06921993
Sponsor's protocol ID
LUSCAP
Acronym
LUSCAP
Status last verified
Apr 2026
First submitted
2 Apr 2025
Last updated
3 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing LUNG ULTRASOUND in people with Pneumonia Childhood and Pneumonia, run by Meyer Children's Hospital IRCCS at 18 sites in 3 countries.

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 3 inclusion and 9 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: looking for participants now, as of the sponsor's last update on 3 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 18 sites in Italy, United States, Israel. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Niccolò Parri, MD (+390555662320/2634, niccolo.parri@meyer.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of participants with antibiotic use (time frame: 7 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 3 Apr 2026.

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