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Diagn. Microbiol. Infect. Dis. · Jul 2013
Randomized Controlled TrialClinical 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.
- Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. deliberato@einstein.br
- Diagn. Microbiol. Infect. Dis. 2013 Jul 1;76(3):266-71.
AbstractBiomarkers 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.Copyright © 2013 Elsevier Inc. All rights reserved.
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