MULTI-CAPCombined Use of a Respiratory Broad Panel MULTIplex PCR and Procalcitonin to Reduce Antibiotics Exposure in Patients With Severe Community-Acquired Pneumonia: a Multicentre, Parallel-group, Open-label, Randomized Controlled Trial.

Antibiotic therapy according to the result of mPCR (device)

The effectiveness of a management combining a broad panel respiratory mPCR and an algorithm of early antibiotic de-escalation and discontinuation based on both the mPCR results and the procalcitonin in severe CAP, as compared to a conventional strategy

Mortality at 28 (D28) and 90 days (D90);

Number of defined daily dose (DDD) per 100 patient days of broad- and narrow-spectrum antibiotics

Antibiotics duration at D28

Number of organ-failure free days (based on SOFA) at D28

Incidence rates of bacterial superinfections at D28

Incidence rates of colonization/infection with multidrug resistant bacteria and Clostridium difficile infections at D28

Incidence rates of relapse (same pathogen) or reinfection (another pathogen) at D28

Duration of ICU and hospital stay

Cost of the total hospital admissions (including 90-day repeated admissions), ICU costs, cost of the microbiological diagnostic workup;

Incremental / decremental cost effectiveness ratio in cost per treatment success (90-day composite of all-cause death and infection recurrence).

Sensitivity, specificity, and likelihood ratios of the broad panel mPCR Film Array for the diagnosis of pneumonia, taking the conventional microbiological tests as reference

Euroquol questionary (EQ-5D-3L)

To assess the operational values of the broad panel mPCR Film Array for the diagnosis of ventilator associated pneumonia (in the intervention group only).