title: [Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment of sepsis patients].
abstract: Objective:To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU).Methods:A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage.In the procalcitonin-guided group, a non-binding advice to discontinue antibiotics was provided if procalcitonin concentration had decreased by 90% or more of its peak value or to 0.25 μg/L or lower.In the regular antibiotic group, patients were treated according to principle of antimicrobial usage.The general status of the patient, antimicrobial drug use time, length of ICU stay, hospital stay time, number of cases of recurrence in 28 days and number of cases of death in 28 days were compared between the two groups.Results:There were no statistical significance in age, gender, blood culture positive rate, and chronic underlying diseases (P>0.05). While APACHE Ⅱ score of PCT group was (22.7±4.7) points, which was higher than that of RAT group (19.9±4.2) (P<0.05). Log Rank test results showed that the time of antimicrobial drug usage was significantly reduced in PCT group than RAT group [days: 8.3±0.3, 95% confidence interval (95%CI7.9-9.1) vs 10.1±0.4, 95% confidence interval (95%CI9.2-11.3), Log Rank value 31.85,P=0.000]. There was no significant difference in length of hospital stay, ICU stay time, number of cases of recurrence in 28 days and number of death in 28 days between two groups (P>0.05).Conclusion:Procalcitonin guidance stimulates reduction of duration of treatment and daily defined doses in critically ill patients with a presumed bacterial infection.This reduction does not affect the length of hospital stay, ICU stay time, number of cases of recurrence in 28 days and number of death in 28 days.
authors.affiliation: Department of Intensive Care Medicine, Northern Jiangsu People's Hospital, Yangzhou 225001, China.
authors.forename: X L
authors.initials: XL
authors.lastname: Xu
authors.forename: F D
authors.initials: FD
authors.lastname: Yan
authors.forename: J Q
authors.initials: JQ
authors.lastname: Yu
authors.forename: Q H
authors.initials: QH
authors.lastname: Chen
authors.forename: H
authors.initials: H
authors.lastname: Lin
authors.forename: R Q
authors.initials: RQ
authors.lastname: Zheng
mesh_terms: D000900:Anti-Bacterial Agents; D001424:Bacterial Infections; D015415:Biomarkers; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D011446:Prospective Studies; D011498:Protein Precursors; D012008:Recurrence; D018805:Sepsis
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Antibiotics; Procalcitonin; Sepsis