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Procalcitonin antibiotic treatment

Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
J C de Jonge, D W de Lange, E A Bij de Vaate, H van Leeuwen, J E Arends
- Inappropriate use of antibiotics in patients without bacterial infection contributes significantly to worldwide antibiotic resistance.- The goal of this review is to summarise evidence from randomised trials investigating the value of the biomarker procalcitonin (PCT) in patients with symptoms of a bacterial infection in the emergency department (ED) and intensive care (IC).- In patients with a lower respiratory infection in the ED, RCTs demonstrate that withholding or shortening of antibiotic treatment in patients with low PCT levels does not lead to a change in clinical outcome...
2016: Nederlands Tijdschrift Voor Geneeskunde
Yang Yang, Yang Lu, Xin He, Hongwei Zhao, Donghao Wang, Wanhua Wang
BACKGROUND: This study was conducted to observe the clinical efficacy of long-term piperacillin-tazobactam (TZP) infusion and identify the factors affecting its curative effect against pneumonia in patients who had undergone surgery for abdominal tumor. METHODS: The 100 patients were divided into four clinical groups according to the severity of their infection: Simple pneumonia, pneumonia with pleural effusion, pneumonia and atelectasis, and severe pneumonia. Each group of patients was then divided into control and treatment groups using a completely random design...
October 3, 2016: Surgical Infections
Katrin Straubhaar, Philipp Schuetz, Claudine Angela Blum, Nicole Nigro, Briel Matthias, Mirjam Christ-Crain, Beat Mueller, Step Study Group
PRINCIPLES: In-hospital care of patients with community-acquired pneumonia (CAP) varies across hospitals. Understanding of the underlying factors is the basis for tailored quality improvements. Using data from a randomised controlled Swiss-wide multicentre trial, we compared length of stay (LOS) and other patient outcomes according to (A) the use of a procalcitonin (PCT)-based antibiotic stewardship protocol, (B) institution type (university vs non-university), and (C) historical time period in relation to the introduction of Diagnosis Related Group (DRG) reimbursement (2012)...
2016: Swiss Medical Weekly
Franziska Gies, Eva Tschiedel, Ursula Felderhoff-Müser, Peter-Michael Rath, Joerg Steinmann, Christian Dohna-Schwake
BACKGROUND: Antimicrobially pre-treated children with systemic inflammation often pose a diagnostic challenge to the physician. We aimed to evaluate the additional use of SeptiFast multiplex polymerase chain reaction (PCR) to identify causative pathogens in children with suspected systemic bacterial or fungal infection. METHODS: Prospective observational study in 39 children with systemic inflammatory response syndrome (SIRS) under empiric antibiotic treatment. Primary outcome was the rate of positive blood cultures (BC), compared to the rate of positive SeptiFast (SF) results...
2016: BMC Infectious Diseases
Anokhi J Kapasi, Sabine Dittrich, Iveth J González, Timothy C Rodwell
BACKGROUND: In resource limited settings acute febrile illnesses are often treated empirically due to a lack of reliable, rapid point-of-care diagnostics. This contributes to the indiscriminate use of antimicrobial drugs and poor treatment outcomes. The aim of this comprehensive review was to summarize the diagnostic performance of host biomarkers capable of differentiating bacterial from non-bacterial infections to guide the use of antibiotics. METHODS: Online databases of published literature were searched from January 2010 through April 2015...
2016: PloS One
Sebastian A Wirz, Claudine A Blum, Philipp Schuetz, Werner C Albrich, Christoph Noppen, Beat Mueller, Mirjam Christ-Crain, Philip E Tarr
In a double-blind, randomised, placebo-controlled trial of hospitalised patients with community-acquired pneumonia (CAP), we demonstrated shorter time to clinical stability (TTCS) with adjunct corticosteroid therapy compared with placebo.We did a pre-planned, exploratory analysis of any association between microbiological diagnosis, antibiotic treatment and procalcitonin level and effect of prednisone on TTCS, mortality, and CAP complications (n=726 participants, enrolled between December 2009 and May 2014)...
October 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Mattia Trunfio, Alessia Savoldi, Ottavia Viganò, Antonella d'Arminio Monforte
PURPOSE: Dengue virus is the most frequent arthropod-borne viral infection worldwide. Simultaneously to the growth of its incidence, cases of bacterial coinfection in dengue have been increasingly reported. The clinical course of dual infections may worsen for reciprocal interactions and delays in the diagnosis, so that clinicians should be aware of this eventuality. Therefore, we reviewed literature to provide an overview of the epidemiological, clinical, and physiopathological issues related to bacterial coinfections and bacteremia in dengue...
July 22, 2016: Infection
Shu-Ling Fan, Nancy S Miller, John Lee, Daniel G Remick
Sepsis is the host response to microbial pathogens resulting in significant morbidity and mortality. An accurate and timely diagnosis of sepsis allows prompt and appropriate treatment. This review discusses laboratory testing for sepsis because differentiating systemic inflammation from infection is challenging. Procalcitonin (PCT) is currently an FDA approved test to aid in the diagnosis of sepsis but with questionable efficacy. However, studies support the use of PCT for antibiotic de-escalation. Serial lactate measurements have been recommended for monitoring treatment efficacy as part of sepsis bundles...
September 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Caspar Corti, Markus Fally, Andreas Fabricius-Bjerre, Katrine Mortensen, Birgitte Nybo Jensen, Helle F Andreassen, Celeste Porsbjerg, Jenny Dahl Knudsen, Jens-Ulrik Jensen
BACKGROUND: This study was conducted to investigate whether point-of-care (POC) procalcitonin (PCT) measurement can reduce redundant antibiotic treatment in patients hospitalized with acute exacerbation of COPD (AECOPD). METHODS: One-hundred and twenty adult patients admitted with AECOPD were enrolled in this open-label randomized trial. Patients were allocated to either the POC PCT-guided intervention arm (n=62) or the control arm, in which antibiotic therapy followed local guidelines (n=58)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
K F Bodmann, M Schenker, W Heinlein, M H Wilke
INTRODUCTION: Procalcitonin (PCT) is a well-evaluated biomarker for the detection of severe bacterial infections and monitoring effectiveness of antibiotic therapy. This study aims to evaluate the usefulness of PCT in a clinical routine setting. MATERIALS AND METHODS: Of 358,763 clinical cases from 7 German hospitals in 2012 and 2013, 3854 cases had an ICD-10 code representing sepsis. A total of 1778 cases had pathologic PCT and one episode of infection. Of those, 671 showed a series of measures that was suitable to assess treatment success using PCT reduction...
July 4, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Agnieszka Kordek, Andrzej Torbé, Joanna Tousty, Beata Łoniewska, Wojciech Podraza, Tomasz Nikodemski, Jacek Rudnicki
The aim of this study was to assess the clinical usefulness of blood procalcitonin (PCT) levels for the diagnosis and therapeutic monitoring of early-onset neonatal sepsis (EONS). PCT as well as C-reactive protein (CRP) levels and white blood cell (WBC) count were measured in venous blood from 57 infected and 72 uninfected neonates. Differences between groups for PCT, CRP, and WBC levels were significant. The threshold value on the receiver operating characteristic curve in the prediction of EONS was 5.33 ng/mL for PCT, 9...
June 28, 2016: Clinical Pediatrics
Changyang Lin, Qiyuan Pang
INTRODUCTION: To evaluate the method of procalcitonin (PCT)-guided treatment on antibiotics in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Database including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trails were searched to find relevant trails. Randomized and quasi-randomized trials of PCT-guided treatment in adult patients with AECOPD were included. Effects on primary outcome (i.e., antibiotic prescriptions, mortality, and clinical success) were accessed in this meta-analysis...
June 22, 2016: Clinical Respiratory Journal
Andreas Hohn, Bernhard Heising, Jan-Karl Schütte, Olaf Schroeder, Stefan Schröder
PURPOSE: In critically ill patients, length of antibiotic treatment can be effectively guided by procalcitonin (PCT) protocols. International sepsis guidelines and guidelines on antibiotic stewardship strategies recommend PCT as helpful laboratory marker for a rational use of antibiotics. A number of studies and meta-analyses have confirmed the effectiveness of PCT-protocols for shortening antibiotic treatment without compromising clinical outcome in critically ill patients. But in clinical practice, there is still uncertainty how to interpret PCT levels and how to adjust antibiotic treatment in various infectious situations, especially in the perioperative period...
June 10, 2016: Langenbeck's Archives of Surgery
A Lavrentieva, P Kontou, V Soulountsi, J Kioumis, O Chrysou, M Bitzani
The purpose of this study was to examine the hypothesis that an algorithm based on serial measurements of procalcitonin (PCT) allows reduction in the duration of antibiotic therapy compared with empirical rules, and does not result in more adverse outcomes in burn patients with infectious complications. All burn patients requiring antibiotic therapy based on confirmed or highly suspected bacterial infections were eligible. Patients were assigned to either a procalcitonin-guided (study group) or a standard (control group) antibiotic regimen...
September 30, 2015: Annals of Burns and Fire Disasters
Wei Qian, Gao-Zhong Huang
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are responsible for most mortality in patients with chronic obstructive pulmonary disease (COPD) and are caused mainly by bacterial infection. We analyzed and compared neutrophil CD64 expression (using the ratio of CD64 level in neutrophils to that in lymphocytes as an index), serum C-reactive protein (CRP), procalcitonin (PCT) levels, white blood cell (WBC) count, and neutrophil percentage among healthy subjects and patients with stable COPD or AECOPD...
August 2016: Immunological Investigations
Jin-Xiang Wang, Shu-Ming Zhang, Xiao-Hui Li, Yao Zhang, Zhen-Yang Xu, Bin Cao
OBJECTIVE: The majority of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have low serum procalcitonin (PCT) values. The aim of this study was to determine whether these patients may benefit from antibiotic treatment. METHODS: A total of 457 patients with AECOPD were screened; 194 patients with AECOPD and PCT <0.1 ng/ml were assigned randomly to an antibiotic group or a control group. In the per-protocol (PP) population, the antibiotic group subjects were required to have used antibiotics for at least 3 days, and the control group subjects were required not to have used antibiotics within the 10 days after admission...
July 2016: International Journal of Infectious Diseases: IJID
Amel M Soliman, Sohair R Fahmy, Amany A Sayed, Asmaa A Abd El-Latif
BACKGROUND: Sepsis remains a major problem for both scientists and clinicians. Cecal ligation and puncture (CLP) is considered the gold standard for animal models of sepsis. The undesirable side effects of certain antibiotics have forced scientists to discover new, natural, and safe antimicrobial agents, such as cephalopods, which are known to display significant antimicrobial activity. OBJECTIVES: The present investigation aims to evaluate the in vitro and in vivo antibacterial and antiseptic efficacy of Sepia officinalis body tissue (SOBT) extract and S...
January 2016: Jundishapur Journal of Microbiology
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