An interventional study of Electronic alert and Structured communication of test results in Pneumonia, Pneumonia, Viral and Pneumonia, Bacterial, sponsored by Jonathan Baghdadi. Completed at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-14.
Sponsored by Jonathan Baghdadi · Not applicable, Interventional, and Diagnostic
The goal of this prospective randomized study is to improve antibiotic use among hospitalized patients with suspected pneumonia. An alert was built into the electronic health record to guide use of diagnostic testing based on probability of bacterial pneumonia. Patients with test results suggesting viral infection will be randomized to either: (1) receive a structured communication from the antimicrobial stewardship team to de-escalate antibiotics or (2) usual care.
Low-risk patients with viral pneumonia do not benefit from and may be harmed by antibiotic therapy. In this study, an alert will appear in the electronic health record of patients undergoing molecular diagnostic testing for respiratory symptoms that provides options for diagnostic testing based on pre-test probability of bacterial infection. Patients with test results suggesting possible viral infection will be randomized to either usual care or to receive test results along with structured guidance from antimicrobial stewardship to consider discontinuing or de-escalating antibiotics. This guidance, which will include an explicit calculation of the post-test probability of bacterial infection based on considering risk factors, vital signs, symptoms, and available imaging, will be communicated to the primary care team via direct electronic message and a summary note in the patient's chart. The final decision on whether to continue antibiotic therapy will be up to the primary team. The primary outcome of interest will be in-hospital antibiotic use. Safety outcomes will include length of stay, readmissions, hospital-free days, and mortality.
2,045 studies on the registry are indexed under Pneumonia; 284 are open to participants now.
This study's enrollment of 107 is close to the median of 106 across 1,247 interventional studies indexed under Pneumonia.
Browse Pneumonia studies →This is the only study on the registry with Jonathan Baghdadi as lead sponsor.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
An electronic health record alert will guide diagnostic testing for pneumonia. For patients with low or moderate probability of bacterial pneumonia, test results will be communicated to the primary team with guidance to consider discontinuing or de-escalating antibiotics.
Behavioral: Electronic alert · Behavioral: Structured communication of test results
An electronic health record alert will guide diagnostic testing for pneumonia. The primary care team will access and interpret test results and decide upon composition and duration of antimicrobial without external guidance.
Behavioral: Electronic alert
An alert will appear in the electronic health record that provides options for diagnostic testing based on low, medium, or high probability of bacterial pneumonia.
A clinical research team member will send an electronic message to the primary care team on behalf of the antimicrobial stewardship program with structured guidance to stop or de-escalate antibiotics and document these recommendations in the patient's chart.
Hospital antibiotic days of therapy
The aggregate sum of days for which any amount of a specific antimicrobial agent was administered during the hospital encounter, from arrival in the emergency department or on the hospital ward until discharge.
Time frame: Up to 90 days after randomization
Hospital length of stay
Duration of hospitalization from admission to discharge
Time frame: Up to 90 days after randomization
In-hospital mortality
Death or discharge to hospice during initial hospitalization for any cause
Time frame: Up to 90 days after randomization
Readmissions within 30-days of randomization
Readmissions for any cause within 30-days of randomization
Time frame: Within 30 days after randomization
C. difficile infections in the 30-days post-randomization
Positive test for C. difficile associated with initiation of antibiotics targeting C. difficile.
Time frame: Within 30 days after randomization
Acute kidney injury
Defined by an elevation in creatinine of \> 0.5mg/dl or 2x baseline in a patient without previous end-stage renal disease.
Time frame: Within 14 days of randomization
Ventilator-free days in the 30-days post-randomization
Days without a requirement for mechanical ventilation in the 30 days after randomization.
Time frame: 30 days after randomization.
Hospital-free days in the 30-days post-randomization
Days without hospitalization in the 30 days after randomization.
Time frame: 30 days after randomization.
Antibiotic de-escalations within 72 hours after initiation
Including narrowing, discontinuing, or converting the route of administration from intravenous to oral.
Time frame: 3 days after randomization.
Plan to share: No
This study is completed, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.
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