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Procalcitonin antibiotic treatment

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https://www.readbyqxmd.com/read/28711318/procalcitonin-guided-decision-making-for-duration-of-antibiotic-therapy-in-neonates-with-suspected-early-onset-sepsis-a-multicentre-randomised-controlled-trial-neopins
#1
Martin Stocker, Wendy van Herk, Salhab El Helou, Sourabh Dutta, Matteo S Fontana, Frank A B A Schuerman, Rita K van den Tooren-de Groot, Jantien W Wieringa, Jan Janota, Laura H van der Meer-Kappelle, Rob Moonen, Sintha D Sie, Esther de Vries, Albertine E Donker, Urs Zimmerman, Luregn J Schlapbach, Amerik C de Mol, Angelique Hoffman-Haringsma, Madan Roy, Maren Tomaske, René F Kornelisse, Juliette van Gijsel, Eline G Visser, Sten P Willemsen, Annemarie M C van Rossum
BACKGROUND: Up to 7% of term and late-preterm neonates in high-income countries receive antibiotics during the first 3 days of life because of suspected early-onset sepsis. The prevalence of culture-proven early-onset sepsis is 0·1% or less in high-income countries, suggesting substantial overtreatment. We assess whether procalcitonin-guided decision making for suspected early-onset sepsis can safely reduce the duration of antibiotic treatment. METHODS: We did this randomised controlled intervention trial in Dutch (n=11), Swiss (n=4), Canadian (n=2), and Czech (n=1) hospitals...
July 12, 2017: Lancet
https://www.readbyqxmd.com/read/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#2
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28700964/clinical-and-laboratory-predictors-of-infectious-complications-in-patients-after-out-of-hospital-cardiac-arrest
#3
Josef Kroupa, Jiri Knot, Jaroslav Ulman, Frantisek Bednar, Alena Dohnalova, Zuzana Motovska
PURPOSE: Identification of clinical and laboratory predictors related to Infectious Complications (ICs) in patients after Out-of-Hospital Cardiac Arrest (OHCA). METHODS: Patients, aged >18, after an OHCA between 9/2013 and 11/2015, surviving >24h, were studied. RESULTS: Study group consisted of 42 patients (mean age 63.4years, 88.1% men). Forty percent of patients had IC; lower respiratory tract infections were most common (87.5% of cases)...
July 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28665787/effects-of-procalcitonin-testing-on-antibiotic-use-and-clinical-outcomes-in-patients-with-upper-respiratory-tract-infections-an-individual-patient-data-meta-analysis
#4
Jonas Odermatt, Natalie Friedli, Alexander Kutz, Matthias Briel, Heiner C Bucher, Mirjam Christ-Crain, Olaf Burkhardt, Tobias Welte, Beat Mueller, Philipp Schuetz
BACKGROUND: Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI). METHODS: A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016...
June 29, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28622967/new-markers-of-urinary-tract-infection
#5
REVIEW
Anna Masajtis-Zagajewska, Michal Nowicki
Urinary tract infection (UTI) is the most common bacterial infection independent of age. It is also one of the most common causes of hospitalizations for infections among elderly people and the most common indication for antibiotic prescriptions in primary care. Both diagnostics and management of lower and upper urinary tract infections provide challenges in clinical practice due to their high prevalence and recurrence, and worldwide increase of antibiotic resistance. The clinical symptoms of UTI are often uncharacteristic or asymptomatic...
August 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28587330/principles-of-antibiotic-application-in-children-with-lobar-pneumonia-step-up-or-step-down
#6
Yan Li, Feng Han, Yan Yang, Jianwei Chu
In order to provide a scientific basis for rational use of antibiotics, we studied and compared the therapeutic effects of step-down and step-up antibiotic treatment schemes in children with lobar pneumonia. Eighty cases of children with lobar pneumonia were enrolled in this study and were randomly divided into two groups: The observation group and the control group, with 40 cases in each group. In the observation group, there were 23 cases with mild and 17 cases with severe lobar pneumonia, and in the control group, 25 were mild and 15 were severe cases...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28578344/the-comparison-of-procalcitonin-guidance-administer-antibiotics-with-standard-guidelines-on-antibiotic-therapy-in-children-with-lower-respiratory-tract-infections-a-retrospective-study-in-china
#7
Guo Wu, Gao Wu, Shuxie Wu, Hanbin Wu
OBJECTIVE: To establish the efficacy of an algorithm based on the biomarker procalcitonin (PCT) to reduce antibiotic exposure in pediatric patients with lower respiratory tract infection (LRTI). MATERIALS AND METHODS: The clinical data of 357 patients (age of <14 years) who were discharged home with lower respiratory tract infections(LRTI) from Jan 1, 2010 to Jul 31, 2016, were analyzed. The antibiotic exposure, antibiotic prescription rate, length of hospital stay and antibiotic-associated adverse effects were compared between PCT group (n=183) and standard group (n=174) using SAS 9...
June 1, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28504784/current-clinical-controversies-in-the-management-of-sepsis
#8
J Cohen
Sepsis remains a challenging clinical problem requiring prompt diagnosis and optimal clinical management if the continuing high mortality is to be contained. In this brief review I consider four specific questions that are the subject of ongoing controversy. First, whether the new 'Sepsis-3' definitions will be helpful, in particular in improving diagnosis, or whether the rapid move towards precision medicine will make the definition redundant. Second, should we routinely use combinations of antibiotics for the empiric treatment of sepsis...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28502892/biomarkers-kinetics-in-the-assessment-of-ventilator-associated-pneumonia-response-to-antibiotics-results-from-the-biovap-study
#9
Pedro Póvoa, Ignacio Martin-Loeches, Paula Ramirez, Lieuwe D Bos, Mariano Esperatti, Joana Silvestre, Gisela Gili, Gemma Goma, Eugenio Berlanga, Mateu Espasa, Elsa Gonçalves, Antoni Torres, Antonio Artigas
PURPOSE: Our aim was to evaluate the role of biomarker kinetics in the assessment of ventilator-associated pneumonia (VAP) response to antibiotics. MATERIALS AND METHODS: We performed a prospective, multicenter, observational study to evaluate in 37 microbiologically documented VAP, the kinetics of C-reactive protein (CRP), procalcitonin (PCT), mid-region fragment of pro-adrenomedullin (MR-proADM). The kinetics of each variable, from day 1 to 6 of therapy, was assessed with a time dependent analysis comparing survivors and non-survivors...
May 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28484421/the-randomized-controlled-strawinski-trial-procalcitonin-guided-antibiotic-therapy-after-stroke
#10
Lena Ulm, Sarah Hoffmann, Darius Nabavi, Marcella Hermans, Bruno-Marcel Mackert, Frank Hamilton, Ingo Schmehl, Gerhard-Jan Jungehuelsing, Joan Montaner, Alejandro Bustamante, Mira Katan, Andreas Hartmann, Stefan Ebmeyer, Christiane Dinter, Jan C Wiemer, Sabine Hertel, Christian Meisel, Stefan D Anker, Andreas Meisel
BACKGROUND: Pneumonia is among the most common acute complications after stroke and is associated with poor long-term outcome. Biomarkers may help identifying stroke patients at high risk for developing stroke-associated pneumonia (SAP) and to guide early treatment. AIMS: This trial investigated whether procalcitonin (PCT) ultrasensitive (PCTus)-guided antibiotic treatment of SAP can improve functional outcome after stroke. METHODS: In this international, multicenter, randomized, controlled clinical trial with blinded assessment of outcomes, patients with severe ischemic stroke in the middle cerebral artery territory were randomly assigned within 40 h after symptom onset to PCTus-based antibiotic therapy guidance in addition to stroke unit care or standard stroke unit care alone...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28480770/an-update-on-the-pharmacotherapeutic-management-of-lower-respiratory-tract-infections
#11
Mario Cazzola, Paola Rogliani, Stefano Aliberti, Francesco Blasi, Maria Gabriella Matera
Our knowledge about lower respiratory tract infections (LRTIs) has improved substantially in the last years, but the management of respiratory infections is still a challenge and we are still far from using precision medicine in their treatment. Areas covered: The approaches developed in recent years to improve the pharmacotherapeutic management of LRTIs, such as novel diagnostic assays to facilitate medical decision-making, attempts for selecting an optimal empiric antibiotic regimen, and the role of new and possibly unproven adjunctive therapies, are described...
July 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28471695/current-use-and-potential-role-of-procalcitonin-in-the-diagnostic-work-up-and-follow-up-of-febrile-neutropenia-in-hematological-patients
#12
REVIEW
Benedetto Bruno, Alessandro Busca, Stefano Vallero, Stefania Raviolo, Nicola Mordini, Luca Nassi, Alessandro Cignetti, Ernesta Audisio, Moreno Festuccia, Alessandra Corsetti, Lorella Depaoli, Maura Faraci, Concetta Micalizzi, Silvia Corcione, Massimo Berger, Francesco Saglio, Paola Caropreso, Giulio Mengozzi, Vincenzo Squadrone, Francesco Giuseppe De Rosa, Luisa Giaccone
Febrile neutropenia (FN) represents a life-threatening complication in hematological malignancies. Its etiology is most often due to infections even though FN of other origins, such as tumor-related fever and non-infectious inflammation, should rapidly be ruled out. Initially, C-reactive protein and, more recently, procalcitonin (PCT) have been proposed as useful biomarkers for differential diagnosis. PCT was shown to be a good biomarker of bacterial infections and their clinical outcomes. Definition of standard cut-offs and design of PCT-guided treatment protocols remain however to be defined...
June 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28468981/human-neutrophil-lipocalin-in-activated-whole-blood-is-a-specific-and-rapid-diagnostic-biomarker-of-bacterial-infections-in-the-respiratory-tract
#13
Per Venge, Ann-Katrin Eriksson, Lena Douhan-Håkansson, Karlis Pauksen
The distinction between bacterial and viral causes of infections of the respiratory tract is a major but important clinical challenge. We investigated the diagnostic performance of human neutrophil lipocalin (HNL) in respiratory tract infections compared to those of C-reactive protein (CRP) and procalcitonin (PCT). Patients were recruited from the emergency department and from a primary care unit (n = 162). The clinical diagnosis with regard to bacterial or viral cause of infection was complemented with objective microbiological/serological testing...
July 2017: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/28459407/-effect-of-bronchoalveolar-lavage-with-fiberoptic-bronchoscopy-combined-with-vibration-sputum-drainage-on-mechanically-ventilated-patients-with-severe-pneumonia-a-prospective-randomized-controlled-trial-in-286-patients
#14
Zeya Shi, Yuelan Qin, Yimin Zhu, Xiaoji Pan, Xu Zhou, Yuting Tan, Yanhui Liu
OBJECTIVE: To investigate the curative effect of bronchoalveolar lavage with fiberoptic bronchoscopy combined with vibration sputum drainage in the treatment of severe pneumonia patients undergoing mechanical ventilation (MV). METHODS: A prospective randomized controlled trial was conducted. 286 severe pneumonia patients undergoing MV admitted to intensive care unit (ICU) of Hunan People's Hospital from January 2014 to July 2016 were enrolled, and they were divided into control group and observation group according to random number table, with 143 patients in each group...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28427133/-effects-of-application-of-vancomycin-in-the-early-stage-of-patients-with-extremely-severe-burn
#15
Z Zhu, G W Cao, J J Bao, Z H Hu, Z Shen, H Tao, B Cao, F Xu
Objective: To evaluate the effects of application of vancomycin in the early stage of patients with extremely severe burn, in order to provide reference to drug for anti-infection treatment in the early stage of patients with extremely severe burn. Methods: Data of 15 patients of Kunshan explosion on August 2nd, 2014, admitted to the Department of Intensive Care in our hospital were retrospectively analyzed. The clinical efficacy of continuously intravenous dripping of vancomycin (combined with imipenem) in the early stage of burns (before and on post burn day 14) was analyzed...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28426811/procalcitonin-for-selecting-the-antibiotic-regimen-in-outpatients-with-low-risk-community-acquired-pneumonia-using-a-rapid-point-of-care-testing-a-single-arm-clinical-trial
#16
Mar Masiá, Sergio Padilla, Victoria Ortiz de la Tabla, Matilde González, Cristina Bas, Félix Gutiérrez
OBJECTIVE: We aimed to assess the role of procalcitonin (PCT) to guide the initial selection of the antibiotic regimen for low-risk community-acquired pneumonia (CAP). METHODS: A single-arm clinical trial was conducted including outpatients with CAP and Pneumonia Severity Index risk classes I-II. Antimicrobial selection was based on the results of PCT measured with a rapid point-of-care testing. According to serum PCT levels, patients were assigned to two treatment strategies: oral azithromycin if PCT was <0...
2017: PloS One
https://www.readbyqxmd.com/read/28391235/is-postoperative-decrease-of-serum-albumin-an-early-predictor-of-complications-after-major-abdominal-surgery-a-prospective-cohort-study-in-a-european-centre
#17
Ismail Labgaa, Gaëtan-Romain Joliat, Amaniel Kefleyesus, Styliani Mantziari, Markus Schäfer, Nicolas Demartines, Martin Hübner
OBJECTIVE: To test postoperative serum albumin drop (ΔAlb) as a marker of surgical stress response and early predictor of clinical outcomes. DESIGN: Prospective cohort study (NCT02356484). Albumin was prospectively measured in 138 patients undergoing major abdominal surgery. Blood samples were collected before surgery and on postoperative days 0, 1 2 and 3. ΔAlb was compared to the modified estimation of physiologic ability and surgical stress (mE-PASS) score and correlated to the performances of C reactive protein (CRP), procalcitonin (PCT) and lactate (LCT)...
April 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28388301/procalcitonin-biomarker-algorithm-reduces-antibiotic-prescriptions-duration-of-therapy-and-costs-in-chronic-obstructive-pulmonary-disease-a-comparison-in-the-netherlands-germany-and-the-united-kingdom
#18
Marloes E van der Maas, Gertjan Mantjes, Lotte M G Steuten
Antibiotics are often recommended as treatment for patients with chronic obstructive pulmonary disease (COPD) exacerbations. However, not all COPD exacerbations are caused by bacterial infections and there is consequently considerable misuse and overuse of antibiotics among patients with COPD. This poses a severe burden on healthcare resources such as increased risk of developing antibiotic resistance. The biomarker procalcitonin (PCT) displays specificity to distinguish bacterial inflammations from nonbacterial inflammations and may therefore help to rationalize antibiotic prescriptions...
April 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28290130/the-choosing-wisely-initiative-in-infectious-diseases
#19
REVIEW
Clara Lehmann, Reinhard Berner, Johannes R Bogner, Oliver A Cornely, Katja de With, Susanne Herold, Winfried V Kern, Sebastian Lemmen, Mathias W Pletz, Bernhard Ruf, Bernd Salzberger, Hans Jürgen Stellbrink, Norbert Suttorp, Andrew J Ullmann, Gerd Fätkenheuer, Norma Jung
OBJECTIVE: "Choosing Wisely" is a growing international campaign aiming at practice changes to improve patient health and safety by both, conduct of essential and avoidance of unnecessary diagnostic, preventive and therapeutic procedures. The goal is to create an easily recognizable and distributable list ("Choosing Wisely items") that addresses common over- and underuse in the management of infectious diseases. METHODS: The German Society of Infectious Diseases (DGI) participates in the campaign "Klug Entscheiden" by the German Society of Internal Medicine...
June 2017: Infection
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#20
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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