• Antonia-Panagiota Georgopoulou, Athina Savva, Evangelos J Giamarellos-Bourboulis, Marianna Georgitsi, Maria Raftogiannis, Nicolaos Antonakos, Efterpi Apostolidou, Dionyssia-Pinelopi Carrer, George Dimopoulos, Aggelos Economou, George Efthymiou, Nearchos Galanakis, Labrini Galani, Panagiotis Gargalianos, Ilias Karaiskos, Chrisostomos Katsenos, Dimitra Kavatha, Evangelos Koratzanis, Panagiotis Labropoulos, Malvina Lada, George Nakos, Evgenia Paggalou, George Panoutsopoulos, Michael Paraschos, Ioannis Pavleas, Konstantinos Pontikis, Garyfallia Poulakou, Athanassios Prekates, Styliani Sybardi, Maria Theodorakopoulou, Christina Trakatelli, Panagiotis Tsiaoussis, Charalambos Gogos, Helen Giamarellou, Apostolos Armaganidis, Michael Meisner, and Hellenic Sepsis Study Group.
• 2nd Department of Internal Medicine, Sismanogleion Athens Hospital, Athens 15126, Greece.
• J Crit Care. 2011 Jun 1;26(3):331.e1-7.

PurposeThe objective of this study is to define if early changes of procalcitonin (PCT) may inform about prognosis and appropriateness of administered therapy in sepsis.MethodsA prospective multicenter observational study was conducted in 289 patients. Blood samples were drawn on day 1, that is, within less than 24 hours from advent of signs of sepsis, and on days 3, 7, and 10. Procalcitonin was estimated in serum by the ultrasensitive Kryptor assay (BRAHMS GmbH, Hennigsdorf, Germany). Patients were divided into the following 2 groups according to the type of change of PCT: group 1, where PCT on day 3 was decreased by more than 30% or was below 0.25 ng/mL, and group 2, where PCT on day 3 was either increased above 0.25 ng/mL or decreased less than 30%.ResultsDeath occurred in 12.3% of patients of group 1 and in 29.9% of those of group 2 (P < .0001). Odds ratio for death of patients of group 1 was 0.328. Odds ratio for the administration of inappropriate antimicrobials of patients of group 2 was 2.519 (P = .003).ConclusionsChanges of serum PCT within the first 48 hours reflect the benefit or not of the administered antimicrobial therapy. Serial PCT measurements should be used in clinical practice to guide administration of appropriate antimicrobials.Copyright © 2011 Elsevier Inc. All rights reserved.

26 keywords...

hide…