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Procalcitonin antibiotic treatment

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https://www.readbyqxmd.com/read/29137105/urgent-laparoscopic-ureterolithotomy-for-proximal-ureter-stones-accompanied-with-obstructive-pyelonephritis-is-it-safe-and-effective-without-preoperative-drainage
#1
Huan Yang, Xiao Yu, Ejun Peng, Cong Li, Lei Cui, Xing Zeng, Shen Wang, Chao Wei, Zhihua Wang, Xiaolin Guo, Zhiqiang Chen, Zhangqun Ye, Shaogang Wang, Chenming Zhao
To evaluate the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of proximal ureteral stones accompanied with obstructive pyelonephritis without preoperative drainage.We retrospectively reviewed 21 cases of proximal ureteral stones with infected kidney undergoing RLU between July 2013 and September 2016. Stone-induced obstructive infected hydronephrosis was diagnosed using blood and urine tests and imaging modalities. Empirical effective broad spectrum antibiotic therapy was initiated immediately, and then urgent RLU was performed without preoperative drainage...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29120606/management-of-respiratory-infections-with-use-of-procalcitonin-moving-toward-more-personalized-antibiotic-treatment-decisions
#2
Yannick Wirz, Angela Branche, Michel Wolff, Tobias Welte, Vandack Nobre, Konrad Reinhart, Ann R Falsey, Pierre Damas, Albertus Beishuizen, Rodrigo O Deliberato, Yahya Shehabi, Jens-Ulrik S Jensen, Beat Mueller, Philipp Schuetz
Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics...
November 9, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29111402/monitoring-both-procalcitonin-and-c-reactive-protein-in-the-early-period-after-tetralogy-of-fallot-correction-in-children-promotes-rational-antibiotic-use
#3
Radoslaw Jaworski, Ireneusz Haponiuk, Ninela Irga-Jaworska, Mariusz Steffens, Maciej Chojnicki, Konrad Paczkowski, Jacek Zielinski
PURPOSE: This retrospective cohort study aimed to identify the early postoperative kinetics of C-reactive protein (CRP) and procalcitonin (PCT) in children undergoing tetralogy of Fallot (ToF) correction. The ability of these inflammatory markers to guide rational antibiotic usage was also determined. MATERIALS AND METHODS: All consecutive children who underwent ToF correction in 2009-2016 in our referral pediatric cardiac surgery clinic in Gdansk, Poland and did not exhibit infection signs on early postoperative days (POD) were identified...
October 27, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/29108950/amoxicillin-for-acute-lower-respiratory-tract-infection-in-primary-care-subgroup-analysis-by-bacterial-and-viral-etiology
#4
Robin Bruyndonckx, Beth Stuart, Paul Little, Niel Hens, Margareta Ieven, Christopher C Butler, Theo Verheij, Herman Goossens, Samuel Coenen
OBJECTIVE: We aimed to assess the effects of amoxicillin treatment in adult patients presenting to primary care with a lower respiratory tract infection (LRTI) who are infected with a potential bacterial, viral, or mixed bacterial/viral infection. METHODS: The multicenter randomized controlled trial focused on adults with LRTI not suspected for pneumonia. Patients were randomized to receive either antibiotic (amoxicillin 1g) or placebo three times daily for seven consecutive days using computer-generated random numbers (follow-up 28 days)...
November 3, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29059253/a-novel-electronic-algorithm-using-host-biomarker-point-of-care-tests-for-the-management-of-febrile-illnesses-in-tanzanian-children-e-poct-a-randomized-controlled-non-inferiority-trial
#5
RANDOMIZED CONTROLLED TRIAL
Kristina Keitel, Frank Kagoro, Josephine Samaka, John Masimba, Zamzam Said, Hosiana Temba, Tarsis Mlaganile, Willy Sangu, Clotilde Rambaud-Althaus, Alain Gervaix, Blaise Genton, Valérie D'Acremont
BACKGROUND: The management of childhood infections remains inadequate in resource-limited countries, resulting in high mortality and irrational use of antimicrobials. Current disease management tools, such as the Integrated Management of Childhood Illness (IMCI) algorithm, rely solely on clinical signs and have not made use of available point-of-care tests (POCTs) that can help to identify children with severe infections and children in need of antibiotic treatment. e-POCT is a novel electronic algorithm based on current evidence; it guides clinicians through the entire consultation and recommends treatment based on a few clinical signs and POCT results, some performed in all patients (malaria rapid diagnostic test, hemoglobin, oximeter) and others in selected subgroups only (C-reactive protein, procalcitonin, glucometer)...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29050167/-serum-procalcitonin-in-patients-with-pulmonary-infection-and-central-nervous-system-injury
#6
J C Li, L Y Wang, Y F Wang, M H Mei, L Shi, M L Yao, X D Guan, B Ouyang
Objective: To evaluate the influence of serum procalcitonin in the diagnosis and treatment of pulmonary infection in patients with central nervous system injury. Methods: From October 2014 to February 2017, a retrospective study was performed. A total of 1 852 patients were screened in Department of Intensive Care Unite, First Affiliated Hospital of Sun Yat-sen University.Among them, 173 patients were identified with different kinds of infection. Finally, a total of 42 patients with pulmonary infection were enrolled...
October 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29038045/effects-of-procalcitonin-guided-treatment-on-antibiotic-use-and-need-for-mechanical-ventilation-in-patients-with-acute-asthma-exacerbation-meta-analysis-of-randomized-controlled-trials
#7
Wanis H Ibrahim, Kamran Mushtaq, Tasleem Raza, Anand Kartha, Ahmed O Saleh, Rayaz A Malik
OBJECTIVE: The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility or emergency department, or during hospital admission. The secondary outcome was the need for mechanical ventilation. METHODS: An extensive literature search was performed to identify randomized controlled clinical trials (published in English) that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician's discretion for adult participants with mild, moderate, or severe acute asthma exacerbations...
October 14, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29037960/effect-of-procalcitonin-guided-antibiotic-treatment-on-mortality-in-acute-respiratory-infections-a-patient-level-meta-analysis
#8
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Djillali Annane, Konrad Reinhart, Ann R Falsey, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Carolina F Oliveira, Vera Maravić-Stojković, Alessia Verduri, Bianca Beghé, Bin Cao, Yahya Shehabi, Jens-Ulrik S Jensen, Caspar Corti, Jos A H van Oers, Albertus Beishuizen, Armand R J Girbes, Evelien de Jong, Matthias Briel, Beat Mueller
BACKGROUND: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety of procalcitonin-guided treatment in patients with acute respiratory infections from different clinical settings. METHODS: Based on a prespecified Cochrane protocol, we did a systematic literature search on the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, and pooled individual patient data from trials in which patients with respiratory infections were randomly assigned to receive antibiotics based on procalcitonin concentrations (procalcitonin-guided group) or control...
October 13, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#9
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28976777/procalcitonin-in-heart-failure-hic-et-nunc
#10
Natasa Cvetinovic, Andjelka M Isakovic, Mitja Lainscak, Hans-Durk Dungen, Natasa Markovic Nikolic, Goran Loncar
Although procalcitonin (PCT) was evaluated for the first time in the setting of heart failure (HF) in 1999, its utility in HF patients is still under examination. Patients with HF have significantly higher plasma PCT concentrations than healthy subjects and PCT levels are associated with severity of HF. It has been confirmed that higher levels of PCT are associated with worse outcomes, such as increased mortality and higher rate of rehospitalization, in HF patients with no evidence of infection. Furthermore, it has been approved that PCT-guided antibiotic treatment in HF patients reduces duration of antibiotic therapy and improves outcomes...
October 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28957358/drivers-of-antibiotic-prescribing-in-children-and-adolescents-with-febrile-lower-respiratory-tract-infections
#11
Verena Gotta, Philipp Baumann, Nicole Ritz, Aline Fuchs, Gurli Baer, Jessica M Bonhoeffer, Ulrich Heininger, Gabor Szinnai, Jan Bonhoeffer
BACKGROUND: Knowledge of key drivers for antibiotic prescribing in pediatric lower respiratory tract infection (LRTI) could support rational antibiotic use. Thus, we aimed to determine the impact of clinical and laboratory factors on antibiotic prescribing in children and adolescents with febrile LRTI. METHODS: Pediatric patients from the standard care control group of a randomized controlled trial (ProPAED) investigating procalcitonin guided antibiotic treatment in febrile LRTI were included in a multivariate logistic regression analysis to evaluate the impact of laboratory and clinical factors on antibiotic prescribing...
2017: PloS One
https://www.readbyqxmd.com/read/28904072/validation-of-a-novel-assay-to-distinguish-bacterial-and-viral-infections
#12
MULTICENTER STUDY
Isaac Srugo, Adi Klein, Michal Stein, Orit Golan-Shany, Nogah Kerem, Irina Chistyakov, Jacob Genizi, Oded Glazer, Liat Yaniv, Alina German, Dan Miron, Yael Shachor-Meyouhas, Ellen Bamberger, Kfir Oved, Tanya M Gottlieb, Roy Navon, Meital Paz, Liat Etshtein, Olga Boico, Gali Kronenfeld, Eran Eden, Robert Cohen, Helène Chappuy, François Angoulvant, Laurence Lacroix, Alain Gervaix
BACKGROUND: Reliably distinguishing bacterial from viral infections is often challenging, leading to antibiotic misuse. A novel assay that integrates measurements of blood-borne host-proteins (tumor necrosis factor-related apoptosis-inducing ligand, interferon γ-induced protein-10, and C-reactive protein [CRP]) was developed to assist in differentiation between bacterial and viral disease. METHODS: We performed double-blind, multicenter assay evaluation using serum remnants collected at 5 pediatric emergency departments and 2 wards from children ≥3 months to ≤18 years without (n = 68) and with (n = 529) suspicion of acute infection...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28898742/neutrophil-cd64-c-reactive-protein-and-procalcitonin-in-the-identification-of-sepsis-in-the-icu-post-test-probabilities
#13
Joel Jämsä, Tero Ala-Kokko, Virva Huotari, Pasi Ohtonen, Eeva-Riitta Savolainen, Hannu Syrjälä
PURPOSE: We were interested in whether C-reactive protein (CRP) and procalcitonin (PCT) distinguish sepsis from non-septic controls and whether a combination of CRP, PCT, and neutrophil CD64 improves identification of sepsis in the intensive care unit (ICU). MATERIALS AND METHODS: We analyzed the CRP and PCT concentrations from 27 patients with sepsis and 15 ICU controls. In addition, CD64 on neutrophils was measured using quantitative flow cytometry. We present a multiple marker analysis for sepsis diagnostics combining neutrophil CD64, CRP, and PCT using post-test analysis...
August 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28894729/procalcitonin-for-diagnostics-and-treatment-decisions-in-pediatric-lower-respiratory-tract-infections
#14
Philipp Baumann, Gurli Baer, Jessica Bonhoeffer, Aline Fuchs, Verena Gotta, Ulrich Heininger, Nicole Ritz, Gabor Szinnai, Jan Bonhoeffer
Mortality and morbidity remain high in pediatric lower respiratory tract infections (LRTIs) despite progress in research and implementation of global diagnostic and treatment strategies in the last decade. Still, 120 million annual episodes of pneumonia affect children younger than 5 years each year leading to 1.3 million fatalities with the major burden of disease carried by low- and middle-income countries (95%). The definition of pneumonia is still challenging. Traditional diagnostic measures (i.e., chest radiographs, C-reactive protein) are unable to distinguish viral and from bacterial etiology...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28881002/clinician-targeted-interventions-to-influence-antibiotic-prescribing-behaviour-for-acute-respiratory-infections-in-primary-care-an-overview-of-systematic-reviews
#15
REVIEW
Sarah Kg Tonkin-Crine, Pui San Tan, Oliver van Hecke, Kay Wang, Nia W Roberts, Amanda McCullough, Malene Plejdrup Hansen, Christopher C Butler, Chris B Del Mar
BACKGROUND: Antibiotic resistance is a worldwide health threat. Interventions that reduce antibiotic prescribing by clinicians are expected to reduce antibiotic resistance. Disparate interventions to change antibiotic prescribing behaviour for acute respiratory infections (ARIs) have been trialled and meta-analysed, but not yet synthesised in an overview. This overview synthesises evidence from systematic reviews, rather than individual trials. OBJECTIVES: To systematically review the existing evidence from systematic reviews on the effects of interventions aimed at influencing clinician antibiotic prescribing behaviour for ARIs in primary care...
September 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28837364/to-which-extent-can-we-decrease-antibiotic-duration-in-critically-ill-patients
#16
REVIEW
José Garnacho-Montero, Angel Arenzana-Seisdedos, Jan De Waele, Marin H Kollef
Inadequate empirical antibiotic therapy is associated with higher mortality in critically ill patients with severe infections. Nevertheless, prolonged duration of antibiotic treatment is also potentially harmful. Development of new infections with more resistant pathogens is one of the arguments against the administration of prolonged courses of antibiotics. Areas covered: We aim to describe the optimal duration of antimicrobial therapy in the most common infections affecting critically ill patients. A literature search was performed to identify all clinical trials, observational studies, meta-analysis, and reviews about this topic from PubMed...
November 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28795838/hospital-procalcitonin-testing-and-antibiotic-treatment-of-patients-admitted-for-copd-exacerbation
#17
Peter K Lindenauer, Meng-Shiou Shieh, Mihaela S Stefan, Kimberly A Fisher, Sarah D Haessler, Penelope S Pekow, Michael B Rothberg, Jerry A Krishnan, Allan J Walkey
RATIONALE: Randomized trials suggest that assessment of serum procalcitonin (PCT) levels can be used to safely limit antibiotic use among patients hospitalized for exacerbations of COPD. OBJECTIVES: To determine the impact of PCT testing on antibiotic treatment of patients hospitalized for exacerbations of COPD in routine practice. METHODS: We conducted a series of cross-sectional and longitudinal multivariable analyses using data from 2009-2011 and 2013-2014 from a sample of 505 US hospitals Results: Of 203,177 patients hospitalized for COPD exacerbation in 2013-14, nearly 9 out of 10 were treated with antibiotics...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28795679/-research-progress-of-presepsin-in-sepsis-diagnosis
#18
Hui Yu, Yuanlin Zeng, Congyang Zhou
Sepsis is a frequently met syndrome with complex clinical symptoms and high mortality in emergency department. Early diagnosis of sepsis and timely treatment can improve survival. In recent years, the application of biomarkers [such as procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] are commonly used in the early diagnosis of sepsis, but their specificity and sensitivity are limited because of the long lag of report time. Soluble leukocyte differentiation antigen 14 sub type (sCD14-ST, namely presepsin) is a kind of novel biomarkers...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28794881/procalcitonin-a-promising-diagnostic-marker-for-sepsis-and-antibiotic-therapy
#19
REVIEW
Ashitha L Vijayan, Vanimaya, Shilpa Ravindran, R Saikant, S Lakshmi, R Kartik, Manoj G
BACKGROUND: Sepsis is a global healthcare problem, characterized by whole body inflammation in response to microbial infection, which leads to organ dysfunction. It is becoming a frequent complication in hospitalized patients. Early and differential diagnosis of sepsis is needed critically to avoid unnecessary usage of antimicrobial agents and for proper antibiotic treatments through the screening of biomarkers that sustains with diagnostic significance. MAIN BODY OF ABSTRACT: Current targeting conventional markers (C-reactive protein, white blood cell, tumour necrosis factor-α, interleukins, etc...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28759466/the-current-status-of-biomarkers-for-the-diagnosis-of-nosocomial-pneumonias
#20
Jorge I F Salluh, Vicente C Souza-Dantas, Pedro Póvoa
PURPOSE OF REVIEW: Nosocomial pneumonia is a frequent and severe nosocomial infection divided in two distinct groups: hospital-acquired pneumonia and ventilator-associated pneumonia (VAP). In this context, the VAP is notoriously difficult to diagnose clinically, resulting from the lack of a 'gold standard' method of diagnosis. RECENT FINDINGS: The use of biomarkers may potentially improve the early diagnosis of infections allowing earlier and better identification and treatment...
October 2017: Current Opinion in Critical Care
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