Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: A randomized trial*

Jensen, Jens Ulrik Stæhr; Hein, Lars; Lundgren, Bettina; Bestle, Morten H.; Mohr, Thomas; Andersen, Mads; Thornberg, Klaus J.; Løken, Jesper; Steensen, Morten; Fox, Zoë; Tousi, Hamid; Søe‐Jensen, Peter; Lauritsen, Anne Øberg; Strange, Ditte Gry; Petersen, Pernille Lykke; Reiter, Nanna; Hestad, Søren; Þormar, Katrín; Fjeldborg, Paul; Larsen, K. Kyllesbech; Drenck, Niels-Erik; Østergaard, Christian Richter; Kjær, Jesper; Grarup, Jesper; Lundgren, Jens D

doi:10.1097/ccm.0b013e31821e8791

Cited by 326 publications

(271 citation statements)

References 39 publications

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“…The use of procalcitonin [64,144,145] or similar biomarkers may facilitate discontinuance of antibiotics in a patient with clinical improvement, although one recent study failed to show any benefit of daily procalcitonin measurement [146]. Table 4) should be rapidly referred to an intensive care unit (ICU) In 2004, the "Surviving Sepsis Campaign" guidelines recommended the use of EGDT [147] based on one large randomized trial [93].…”

Section: The Empirical Treatment Must Be Optimized When Microbiology mentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infections and sepsis. The Delphi appropriateness method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. The paper contains seven clusters of statements about the clinical definition and management of infections and sepsis in head and neck cancer patients, which had a consensus. Furthermore, it offers a review of recent literature in these topics

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Section: The Empirical Treatment Must Be Optimized When Microbiology mentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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“…Two recent studies tried to establish a PCT-algorithm useful to manage sepsis antimicrobial therapy based on plasma PCT levels changes with conflicting results. Bouadma and colleagues showed that this algorithm could reduce antibiotic exposure without apparent adverse outcomes [13], while Jansen et al showed a prolonged admission to the intensive care units without any improvement in the survival rate [14].…”

Section: Traditional Biomarkersmentioning

confidence: 99%

Role of presepsin for the evaluation of sepsis in the emergency department

Pizzolato

Ulla

Galluzzo

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

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Sepsis, severe sepsis and septic shock are among the most common conditions handled in the emergency department (ED). According to new Sepsis Guidelines, early diagnosis and treatment are the keys to improve survival. Plasma C-reactive protein (CRP) and procalcitonin (PCT) levels, when associated with documented or suspected infection, are now part of the definitions of sepsis. Blood culture is the gold standard method for detecting microorganisms but it requires too much time for results to be known. Sensitive biomarkers are required for early diagnosis and as indexes of prognosis sepsis. CRP is one of the acute phase proteins synthesized by the liver: it has a great sensitivity but a very poor specificity for bacterial infections. Moreover, the evolution of sepsis does not correlate with CRP plasma changes. In recent years PCT has been widely used for sepsis differential diagnosis, because of its close correlation with infections, but it still retains some limitations and false positivity (such as in multiple trauma and burns). Soluble CD14 subtype (sCD14-ST), also known as presepsin, is a novel and promising biomarker that has been shown to increase significantly in patients with sepsis, in comparison to the healthy population. Studies pointed out the capability of this biomarker for diagnosing sepsis, assessing the severity of the disease and providing a prognostic evaluation of patient outcome. In this mini review we mainly focused on presepsin: we evaluate its diagnostic and prognostic roles in patients presenting to the ED with systemic inflammatory response syndrome (SIRS), suspected sepsis or septic shock.

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“…Однако у крайне тяжелых пациентов с сепсисом в отделениях интенсивной терапии ежедневное изме-рение ПКТ и попытка моментального терапевтического реагирования не имела значимого преимущества в срав-нении со стандартной тактикой ведения [43].…”

Section: пкт при менингитеunclassified

Diagnostic Value of Determining the Level of Procalcitonin in the Practice of an Infectious Disease Specialist

Полякова¹,

БакрадзеД.²,

Таточенко³

et al. 2017

Vopr. sovr. pediatr.

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ВВЕДЕНИЕПрактически каждый ребенок хотя бы один раз в год переносит заболевание, сопровождающееся лихорад-кой [1]. Именно этот симптом заставляет волноваться и родителей, и врачей, что приводит к назначению боль-шого числа лекарственных средств -не только жаро-понижающих, но и системных антибиотиков. Однако лечение лихорадки как таковой не должно быть само-целью: необходимо выяснить причину повышения тем-пературы и, что главное, выделить ту категорию пациен-тов, которым показано незамедлительное лечение, хотя в большинстве случаев лихорадка обусловлена вирус-ной инфекцией и не требует какого-либо лечения [1].Первичными и основными задачами врача при лихо-радке являются дифференциальная диагностика между вирусной и бактериальной инфекцией и выбор тактики ведения пациента, а уже вторичными -снижение температуры тела, особенно с учетом того, что высота лихорадки, как правило, не коррелирует со степенью тяжести заболевания [1].

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Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: A randomized trial*

Abstract: Procalcitonin-guided antimicrobial escalation in the intensive care unit did not improve survival and did lead to organ-related harm and prolonged admission to the intensive care unit. The procalcitonin strategy like the one used in this trial cannot be recommended.

Cited by 326 publications

References 39 publications

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Role of presepsin for the evaluation of sepsis in the emergency department

Diagnostic Value of Determining the Level of Procalcitonin in the Practice of an Infectious Disease Specialist

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