Procalcitonin-guided antibiotic treatment in critically ill patients

Höhn, Andreas; Heising, Bernhard; Schutte, J F; Schroeder, Olaf; Schröder, Stefan

doi:10.1007/s00423-016-1458-4

Cited by 7 publications

(1 citation statement)

References 42 publications

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“…Due to concerns about rising rates of AB resistance, the US government released the "National Action Plan for Combating Antibiotic Resistant Bacteria" recommending that all healthcare facilities implement AB stewardship programs (ASPs) 6,7 . Effective ASPs, with appropriate drug product selection, dosing, route of administration, and duration of antimicrobial therapy, in conjunction with a comprehensive infection control program, have been shown to limit the emergence and transmission of AB-resistant microorganisms 8 .…”

Section: Introductionmentioning

confidence: 99%

Decreased antibiotic exposure using a procalcitonin protocol for respiratory infections and sepsis in US community hospitals (ProCommunity)

DeSear¹,

Thompson‐Leduc

Schooneveld

et al. 2021

Current Medical Research and Opinion

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Objective: Antibiotic overuse leading to antimicrobial resistance is a global public health concern. Clinical trials have demonstrated that procalcitonin-based decision-making for antibiotic therapy can safely decrease inappropriate antibiotic use in patients with respiratory infections and sepsis, but realworld data are scarce. This study sought to assess the impact of a procalcitonin-based antibiotic stewardship program (protocol plus education) on antibiotic use in community hospitals. Methods: An observational, retrospective, matched cohort study was conducted. Eligible patients treated in hospitals with a procalcitonin-based protocol plus education (Procalcitonin cohort hospitals) were matched to patients admitted to facilities without procalcitonin testing (Control cohort hospitals) using a 1:2 ratio. The Control hospitals were facilities where procalcitonin testing was not available on site. Patient matching was based on: (1) age, (2) gender, (3) admission diagnosis code using groupings of the International Classification of Diseases, 10th Revision, (4) whether patients were admitted to the intensive care unit, and (5) whether a blood culture test was performed. Procalcitonin cohort hospitals implemented a quality improvement initiative, where procalcitonin was available, used regularly, and clinicians (physicians and pharmacists) were educated on its use. Results: After adjustment, patients in the Procalcitonin cohort had 1.47 fewer antibiotic days (9.1 vs. 8.5 days, 95%CI: À2.72; À0.22, p ¼ .021). There was no difference in length of stay or adverse clinical outcomes except for increase in acute kidney injury (odds ratio ¼ 1.26, 95%CI: 1.01; 1.58, p ¼ .038). Conclusions: Patients with respiratory infections and sepsis in hospitals utilizing a procalcitonin-based protocol coupled with education received fewer days of antibiotic therapy.

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Section: Introductionmentioning

confidence: 99%

Decreased antibiotic exposure using a procalcitonin protocol for respiratory infections and sepsis in US community hospitals (ProCommunity)

DeSear¹,

Thompson‐Leduc

Schooneveld

et al. 2021

Current Medical Research and Opinion

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Diagnosis and Management of Sepsis and Septic Shock: An Evidence-Based Review

Tulli

2019

Practical Trends in Anesthesia and Intensive Care 2018

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Neue SEPSIS-3-Definition

et al. 2017

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The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?

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Procalcitonin-guided antibiotic treatment in critically ill patients

Cited by 7 publications

References 42 publications

Decreased antibiotic exposure using a procalcitonin protocol for respiratory infections and sepsis in US community hospitals (ProCommunity)

Decreased antibiotic exposure using a procalcitonin protocol for respiratory infections and sepsis in US community hospitals (ProCommunity)

Diagnosis and Management of Sepsis and Septic Shock: An Evidence-Based Review

Neue SEPSIS-3-Definition

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