Optimizing Antibiotic Use in Respiratory Infections: From Evidence to Implementation

Over the past eight years, Noémie Boillat Blanco’s research has concentrated on clinical trials evaluating interventions aimed at optimizing antibiotic prescribing and ensuring patient safety in community-acquired respiratory tract infections. With the growing threat of antibiotic resistance, improving antibiotic has become a critical priority. She designs and tailors interventions to fit specific healthcare settings, enhancing their impact and usability.

• As the Principal Investigator of an NRP72-funded project (SNSF grant 407240_167133/1), she demonstrated that point-of-care procalcitonin (PCT POC) testing led to a cost-effective 26% absolute reduction in 28-day antibiotic prescriptions compared to usual care [1, 2]. These findings contributed to the Swiss Society for Infectious Diseases incorporating procalcitonin into pneumonia treatment guidelines.
• She is also the co-Principal Investigator of the "ImPro" study (SNSF grant 32003B_212429), which evaluates the best strategy for implementing PCT POC in real-world clinical practice to assess its impact on antibiotic use [3].
• In parallel, she leads an IICT-funded proposal, the "PLUS IS LESS" trial (SNSF grant 33IC30_201300): this multicenter study, conducted across nine Swiss emergency departments, assesses a multimodal algorithm combining point-of-care lung ultrasound and procalcitonin testing to guide antibiotic therapy [4].

Selected publications:

[1] Lhopitallier L, Kronenberg A, Meuwly JY, Locatelli I, Müller Y, Senn N, D’Acremont V, Boillat-Blanco N. Procalcitoninand lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomized trial. BMJ 2021; 374: n2132. DOI.

[2] Cisco G, Meier AN, Senn N, Mueller Y, Kronenberg A, locatelli I, Knüsli J, Lhopitallier L, Boillat-Blanco N, Marti J. Cost-effectiveness analysis of procalcitonin and lung ultrasonography guided antibiotic prescription in primary care. Eur J Health Econ 2025; 26: 129. DOI.

[3] Wolfensberger A, Gendolla SC, Dunaiceva J, Plüss-Suard C, Niquille A, Nicolet A, Marti J, Powell BJ, Naef R, Boillat-Blanco N, Mueller Y, Clack L. Systematic method for developing tailored strategies for implementing point-of-care procalcitonin testing to guide antibiotic  prescribing in Swiss primary care: a protocol for a mixed-methods participatory approach. BMJ Open 2025; 15: e091285. DOI.

[4] Bessat C, Bingisser R, Schwendinger M, Bulaty T, Fournier Y, Della Santa V, Pfeil M, Schwab D, Leuppi JD, Heigy N, Steuer S, Roos F, Christ M, Sirova A, Espejo T, Riedel H, Atzl A, Napieralski F, Marti J, Cisco G, Foley RA, Schindler M, Hartley MA, Fayet A, Garcia E, Locatelli I, Albrich WC, Hugli O, Boillat-Blanco N. PLUS-IS-LESS project: Procalcitonin and Lung UltraSonography based antibiotherapy in patients with Lower rESpiratory tract infection in Swiss Emergency Departments: study protocol for a pragmatic stepped-wedge cluster randomized trial. Trials 2024; 25: 86. DOI.