title: Can procalcitonin monitoring reduce the length of antibiotic treatment in bloodstream infections?
abstract: Antibiotic overconsumption and subsequent bacterial multidrug resistance are associated with increased mortality, length of hospitalisation and healthcare costs. Discontinuation of antibiotic treatment in severe infections, such as bloodstream infections (BSIs), is a demanding clinical decision. In this review, we aim to investigate the usefulness of procalcitonin (PCT) monitoring in guiding appropriate treatment duration in BSIs and its impact on clinical outcomes. Data from clinical studies conducted after 2005 that included patients with BSIs indicate that change of PCT is an early indicator for prognosis in terms of survival and, overall, support the usefulness of a PCT-guided clinical algorithm in reducing the duration of antibiotic treatment without compromising survival. Furthermore, the presented data indicate that PCT assessment is helpful in the diagnosis of infective endocarditis. In conclusion, monitoring of PCT together with evaluation of the clinical situation is a valuable tool in reducing the length of antimicrobial treatment in BSIs.
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece. Electronic address: I.Pantelidou@med.uoa.gr.
authors.forename: Iliana-Maria
authors.initials: IM
authors.lastname: Pantelidou
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
authors.forename: Evangelos J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016903:Drug Monitoring / Q000379:methods*; D004358:Drug Therapy / Q000379:methods; D006801:Humans; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000188:drug therapy*; D013995:Time
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Bloodstream infections; Procalcitonin; Treatment duration