Lung ultrasound to guide antibiotic decisions in children with pneumonia

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This prospective, randomized multicenter trial enrolls clinically stable children aged 3–10 who present with signs of lower respiratory tract infection and randomizes them to immediate lung ultrasound (LUS) after clinical assessment versus standard care. Clinicians in both arms may still order chest X-rays or blood tests as needed, and all treatment decisions remain at the treating physician’s discretion. The primary outcome is whether LUS reduces antibiotic prescriptions; secondary aims measure how often LUS changes decisions and compare diagnostic accuracy to current pathways. Enrollment excludes children with recent hospitalization, prior chest imaging, ongoing antibiotics, severe respiratory distress, or conditions that predispose to complicated pneumonia.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* 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:

  1. Respiratory Symptoms: Cough, Tachypnea, Dyspnea (Increased work of breathing), Abnormal findings on auscultation.
  2. Systemic Symptoms: Fever, Hypoxia, Decreased appetite.

     Exclusion Criteria:
* 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:

  1. Recent hospitalization (within the past 14 days)
  2. Prior CXR or any other chest imaging (e.g. CT scan)
  3. Ongoing antibiotic therapy
  4. Hemodynamic instability
  5. Respiratory failure or severe respiratory distress and/or hypoxemia, requiring urgent assessment for conditions such as pneumothorax, hemothorax, or other emergency respiratory conditions
  6. History of aspiration or ab ingestis pneumonia
  7. 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

Where it's running

• Yale New Haven Children's Hospital
  New Haven, Connecticut, United States Recruiting
• Meyer Children's Hospital IRCCS
  Florence, Italy, Italy Recruiting
• ASST Papa Giovanni XXIII
  Bergamo, Italy Recruiting
• IRCCS Sant'Orsola
  Bologna, Italy Recruiting
• IRCCS Istituto Giannina Gaslini
  Genova, Italy Recruiting
• Ospedale Maggiore della Carità
  Novara, Italy Recruiting

Study contacts

• Study coordinator: Niccolò Parri, MD
• Email: niccolo.parri@meyer.it
• Phone: +390555662320/2634

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Other studies for the same condition or treatment. Recruiting studies are listed first.

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.