HAP-FAST

This NIHR funded clinical trial will determine the best way to diagnose Hospital Acquired Pneumonia and its causes.

About

HAP-FAST is a study which tests new pathways for investigating patients who might have pneumonia.

Pneumonia is an infection of the lungs caused by a number of different germs. Between 1 and 2% of patients develop pneumonia while in hospital and this is called Hospital Acquired Pneumonia (HAP for short). Normally, if the doctor thinks you have Pneumonia, they confirm the diagnosis with a chest x-ray and help you provide a sputum (phlegm) sample to identify the germs responsible.

There are two problems with this standard approach to the diagnosis of pneumonia. First, the interpretation of a chest x-ray can be tricky, and some patients are misdiagnosed with HAP when in fact they have an alternative diagnosis.

The second weakness is that growing germs from sputum takes several days and while waiting the doctor must start you on 'best guess' antibiotics which might not kill the right germs.

The consequences of these diagnostic weaknesses are that some patients receive antibiotics they do not need whilst others might receive antibiotics that do not properly treat their pneumonia.

1 in 5 patients who suffer an episode of HAP die during their hospital admission

An alternative to chest x-ray is a CT scan (sometimes called a body scan) and in some studies, CT scans have been shown to help doctors diagnose pneumonia more accurately. In addition, we now have a rapid PCR test that might allow us to determine the cause of HAP quickly enough to help choose the right antibiotics.

In this study we will compare chest x-rays to CT scans – and compare current microbiology tests to a new PCR test. This pilot study is a small-scale version of a future larger study that will clarify if the diagnostic new pathway can safely reduce unnecessary antibiotic use.

The results from this study will be used to help improve diagnosis and treatments for patients with HAP.

FilmArray Machine

Below is an image of the FilmArray machine used in the HAP-FAST study.