Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections

Abstract

Use of procalcitonin to guide initiation and duration of antibiotic treatment in patients with ARI was not associated with higher mortality rates or treatment failure. Antibiotic consumption was significantly reduced across different clinical settings and ARI diagnoses. Further high-quality research is needed to confirm the safety of this approach for non-European countries and patients in intensive care. Moreover, future studies should also establish cost-effectiveness by considering country-specific costs of procalcitonin measurement and potential savings in consumption of antibiotics and other healthcare resources, as well as secondary cost savings due to lower risk of side effects and reduced antimicrobial resistance.

Ventilator-associated pneumonia caused by colistin-resistant KPC-producing Klebsiella pneumoniae: A case report and literature review

“…Multiple studies and a recent Cochrane review [17] have shown that antibiotic therapy guided by procalcitonin values, compared with outcomes in standard therapy, are not burdened with a higher mortality rate or treatment failure and allow significant reductions in consumption, toxicity, and selective pressure related to antibiotic therapy. In our experience, this strategy has been used to treat complex infections [18], including VAP, caused by KPC-Kp [19].…”

Biomarker-guided de-escalation of empirical therapy is associated with lower risk for adverse outcomes

“…In line with these authors' study, we have recently analyzed data from similar trials in which patients were treated according to a procalcitonin algorithm for antibiotic de-escalation and control patients were not treated with this approach [2,3]. We included all published randomized controlled trial data in an individual patient data (IPD) meta-analysis.…”

Procalcitonin-guided antibiotic treatment in critically ill patients

“…The strength of PCT in this context is to rule out bacterial causes in patients presenting with clinically mild to moderate acute respiratory infections in the emergency room or in the outpatient setting [25].…”