Clinical and economic impact of procalcitonin to shorten antimicrobial therapy in septic patients with proven bacterial infection in an intensive care setting

Rodrigo Octavio Deliberato; Alexandre R Marra; Paula Rodrigues Sanches; Marines Dalla Valle Martino; Carlos Eduardo dos Santos Ferreira; Jacyr Pasternak; Angela Tavares Paes; Lilian Moreira Pinto; Oscar Fernando Pavão dos Santos; Michael B Edmond

doi:10.1016/j.diagmicrobio.2013.03.027

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Clinical and economic impact of procalcitonin to shorten antimicrobial therapy in septic patients with proven bacterial infection in an intensive care setting

Journal article

Peer reviewed

Clinical and economic impact of procalcitonin to shorten antimicrobial therapy in septic patients with proven bacterial infection in an intensive care setting

Rodrigo Octavio Deliberato, Alexandre R Marra, Paula Rodrigues Sanches, Marines Dalla Valle Martino, Carlos Eduardo dos Santos Ferreira, Jacyr Pasternak, Angela Tavares Paes, Lilian Moreira Pinto, Oscar Fernando Pavão dos Santos and Michael B Edmond

Diagnostic Microbiology & Infectious Disease, Vol.76(3), pp.266-271

07/2013

DOI: 10.1016/j.diagmicrobio.2013.03.027

PMID: 23711530

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Abstract

Biomarkers such as procalcitonin (PCT) have been studied to guide duration of antibiotic therapy. We aimed to assess whether a decrease in PCT levels could be used to reduce the duration of antibiotic therapy in intensive care unit (ICU) patients with a proven infection without risking a worse outcome. We assessed 265 patients with suspected sepsis, severe sepsis, or septic shock in our ICU. Of those, we randomized 81 patients with a proven bacterial infection into 2 groups: an intervention group in which the duration of the antibiotic therapy was guided by a PCT protocol and a control group in which there was no PCT guidance. In the per-protocol analysis, the median antibiotic duration was 9 days in the PCT group (n = 20) versus 13 days in the non-PCT group (n = 31), P = 0.008. This study demonstrates that PCT can be a useful tool for limiting antimicrobial therapy in ICU patients with documented bacterial infection.

Severe sepsis

Procalcitonin

Antibiotic therapy

Sepsis

Septic shock

Antimicrobial therapy

Cost

Details

Title: Subtitle: Clinical and economic impact of procalcitonin to shorten antimicrobial therapy in septic patients with proven bacterial infection in an intensive care setting
Creators: Rodrigo Octavio Deliberato - Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Alexandre R Marra - Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Paula Rodrigues Sanches - Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Marines Dalla Valle Martino - Microbiology Laboratory Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Carlos Eduardo dos Santos Ferreira - Microbiology Laboratory Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Jacyr Pasternak - Microbiology Laboratory Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Angela Tavares Paes - Statistics Department, Instituto Israelita de Ensino e Pesquisa (IIEP), São Paulo, Brazil
Lilian Moreira Pinto - Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Oscar Fernando Pavão dos Santos - Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Michael B Edmond - Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
Resource Type: Journal article
Publication Details: Diagnostic Microbiology & Infectious Disease, Vol.76(3), pp.266-271
Publisher: Elsevier Inc
DOI: 10.1016/j.diagmicrobio.2013.03.027
PMID: 23711530
ISSN: 0732-8893
eISSN: 1879-0070
Language: English
Date published: 07/2013
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9983905647602771

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