• Journal of critical care · Jun 2015

    Multicenter Study Observational Study

    Procalcitonin-guided therapy may reduce length of antibiotic treatment in intensive care unit patients with secondary peritonitis: A multicenter retrospective study.

    • Emilio Maseda, Alejandro Suarez-de-la-Rica, Víctor Anillo, Eduardo Tamayo, Carlos A García-Bernedo, Fernando Ramasco, Maria-Jose Villagran, Genaro Maggi, Maria-Jose Gimenez, Lorenzo Aguilar, Juan-José Granizo, Antonio Buño, and Fernando Gilsanz.
    • Anesthesiology and Surgical Critical Care Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain. Electronic address: emilio.maseda@gmail.com.
    • J Crit Care. 2015 Jun 1; 30 (3): 537-42.

    PurposeBecause procalcitonin (PCT) might be surrogate for antimicrobial discontinuation in general intensive care units (ICUs), this study explored its use for secondary peritonitis in 4 surgical ICUs (SICUs).MethodsA retrospective study including all consecutive patients with secondary peritonitis, controlled infection source, requiring surgery, and at least 48-hour SICU admission was performed (June 2012-June 2013). Patients were divided following notations in medical records into PCT-guided (notation of PCT-based antibiotic discontinuation) and non-PCT-guided (no notation) groups.ResultsA total of 121 patients (52 PCT-guided, 69 non-PCT-guided) were included. No differences in clinical scores, biomarkers, or septic shock (30 [57.7%] PCT-guided vs 40 [58.0%] non-PCT-guided) were found. Length of intra-SICU (median, 5.0 days; both groups) or in-hospital (median, 20.0 vs 17.5 days) stay, and mortality intra-SICU (9.6% vs 13.0%), 28-day (15.4% vs 20.3%), or in-hospital (19.2% vs 29.0%) were not significantly different (PCT-guided vs non-PCT-guided). In septic shock patients, no mortality differences were found (PCT-guided vs non-PCT-guided): 16.7% vs 22.5% (intra-SICU), 26.7% vs 32.5% (28-day), and 33.3% vs 42.5% (in-hospital). Treatment was shorter in the PCT-guided group (5.1 ±2.1 vs 10.2 ± 3.7 days, P < .001), without differences between patients with and without septic shock.ConclusionProcalcitonin guidance produced 50% reduction in antibiotic duration (P < .001, log-rank test).Copyright © 2014 Elsevier Inc. All rights reserved.

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