Petechiae In Children (PIC) Study
Research type
Research Study
Full title
Petechiae In Children (PIC) Study: Defining A Clinical Decision Rule For The Management Of Fever and Non-Blanching Rashes In Children Including The Role Of Point Of Care Testing For Procalcitonin & Neisseria meningitidis DNA.
IRAS ID
224660
Contact name
Michael D Shields
Contact email
Sponsor organisation
Belfast Health and Social Care Trust
Duration of Study in the UK
3 years, months, days
Research summary
Many children present to hospital with a temperature and a non-blanching rash and most have a viral illness that needs no treatment. Because there is concern that this could be the early phase of the fatal meningococcal meningitis and septicaemia (blood poisoning) such children are given urgent treatment with antibiotics and admitted, often ‘just in case’. The overuse of antibiotics is associated with the emergence of drug resistant bacteria and the unnecessary stay in hospital is distressing for children and their parents. Despite this approach some children are still diagnosed late resulting in death or disability.
There is a paucity of evidence on how best to diagnose early meningococcal disease (MD) in children. National organisations including: the National Institute for Health and Care Excellence (NICE) and the Paediatric Emergency Research UK and Ireland network (PERUKI) have called for further research to develop a a new approach to diagnosis that includes clinical and laboratory data. In particular research is needed to determine the usefulness of rapid point of care testing (POCT) that provides results within 20-30 minutes. Research has already shown that a test (called LAMP-MD) is accurate at detecting meningococcal bacteria on a throat swab and a blood test called (procalcitonin PCT) has value in detecting bacterial infections early.
For meaningful changes in national practice to occur there will need to be a large multicentre study. The aim of the PIC study is to act as a feasibility study for a larger multi-centre study. In the PIC study children with suspected MD will have an additional rapid POCTs performed on a throat swab (LAMP-MD) and on blood (PCT). We will assess the feasibility of performing rapid POCTs in the Emergency situation. No additional throat/blood samples will be taken, the rapids POCTs will be performed using samples taken for routine care.
REC name
HSC REC B
REC reference
17/NI/0169
Date of REC Opinion
25 Sep 2017
REC opinion
Further Information Favourable Opinion