Use of MULTIplex PCR, Procalcitonin, and Sputum Appearance to Reduce Duration of Antibiotic Therapy During Severe COPD EXAcerbation: A Controlled, Randomized, Open-label, Parallel-Group, Multicenter Trial

Inclusion Criteria: * Age ≥ 18 years old * COPD (according to GOLD 2020), whatever the stage (I-IV) * Acute exacerbation (defined as the onset or worsening of one or more of the usual signs/symptoms of COPD) with acute worsening of respiratory symptoms that result in additional therapy) with acute respiratory failure requiring admission to ICU and ventilatory support (invasive mechanical ventilation or non-invasive mechanical ventilation or high-flow nasal oxygen therapy with FiO2 ≥ 50%) * Informed consent of patient, patient's immediate family/ or inclusion in an emergency situation * Affiliation to a social security Exclusion Criteria: * The interval between admission to the hospital and admission to ICU more than 3 days * Antibiotic therapy clearly needed for a suspected or documented extra-respiratory infection * Congenital or acquired immunosuppression (congenital immune deficiency, high-grade hematologic malignancies, use of immunosuppressive drugs in the last 30 days including anti-cancer chemotherapy and antirejection medications, corticosteroid treatment ≥ 20 mg/d prednisone equivalent for at least 14 days, neutropenia, HIV with unknown or known CD4 \<200 / µL in the past 6 months) * Tracheotomy * Bronchiectasis / cystic fibrosis * Moribund patient (imminent death) * Patient deprived of liberty and / or under legal protection measure * Patient already included in MULTI-EXA * Patient already included in a type 1 interventional study on antibiotics * Ongoing pregnancy