title: Procalcitonin is a good tool to guide duration of antibiotic therapy in patients with severe acute pancreatitis.  A randomized prospective single-center controlled trial.
abstract: OBJECTIVE
  To investigate the clinical usefulness of procalcitonin (PCT) for guiding duration of antibiotic therapy in patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  A total of 71 patients with confirmed severe acute pancreatitis from March 2009 to September 2011 in the Department of Critical Care Medicine of Huizhou Municipal Central Hospital, Guangdong, China were enrolled in this study. Procalcitonin was measured daily by a semi-quantitative immunoassay in the study group. Patients were randomly assigned into 2 groups including a PCT-guided group (study group) and a prophylactic antibiotic therapy (control group). Antibiotic therapy in the study group was not applied until clinical signs and symptoms of infection appeared (PCT value was >0.5ng/ml). We discontinued the antibiotic therapy if clinical signs and symptoms of infection improved and PCT was <0.5ng/ml over 3 days. In the control group, antibiotic therapy was administrated for 2 weeks, or antibiotic therapy was continued because of confirmed infection until clinical signs and symptoms of infection disappeared over 3 days.
  
  
  RESULTS
  In the study group (35 patients), the duration of antibiotic therapy and hospitalization was significantly shorter than the control group (36 patients) (10.89+/-2.85 versus 16.06+/-2.48 days, p<0.001, and 16.66+/-4.02 days versus 23.81+/-7.56 days, p<0.001) without negative clinical effects and the cost of hospitalization was significantly lower.
  
  
  CONCLUSIONS
  Procalcitonin is a helpful and safe tool for guiding duration of antibiotic treatment in patients with severe acute pancreatitis.
authors.affiliation: Department of Critical Care Medicine, Guangdong Huizhou Municipal Central Hospital, 41 E'ling North Road, Huizhou of Guangdong 516001, China. gzdd2004@yahoo.com.cn
authors.forename: Rong
authors.initials: R
authors.lastname: Qu
authors.forename: Yan
authors.initials: Y
authors.lastname: Ji
authors.forename: Yun
authors.initials: Y
authors.lastname: Ling
authors.forename: Chu-Yang
authors.initials: CY
authors.lastname: Ye
authors.forename: Si-Ming
authors.initials: SM
authors.lastname: Yang
authors.forename: Yan-Yuan
authors.initials: YY
authors.lastname: Liu
authors.forename: Ri-Yan
authors.initials: RY
authors.lastname: Yang
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Luo
authors.forename: Zhi
authors.initials: Z
authors.lastname: Guo
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D006801:Humans; D010195:Pancreatitis / Q000188:drug therapy*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
chemical_list: D000900:Anti-Bacterial Agents; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide