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Procalcitonin antibiotic treatment

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https://www.readbyqxmd.com/read/28904072/validation-of-a-novel-assay-to-distinguish-bacterial-and-viral-infections
#1
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...
September 13, 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
#2
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
#3
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
#4
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
#5
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...
August 24, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28795838/hospital-procalcitonin-testing-and-antibiotic-treatment-of-patients-admitted-for-copd-exacerbation
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28757818/procalcitonin-assisted-antibiotic-strategy-in-sepsis
#10
Domonkos Trásy, Zsolt Molnár
Sepsis is one of the biggest challenges in critical care nowadays. Defining sepsis is a difficult task on its own and its diagnosis and treatment requires well trained, devoted personnel with interdisciplinary collaboration in order to provide the patients the best chance for survival. Immediate resuscitation, early adequate antimicrobial therapy, source control and highly sophisticated organ support on the intensive care units are all inevitable necessities for successful recovery. To help fast and accurate diagnosis biomarkers have been measured for decades...
May 2017: EJIFCC
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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