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Procalcitonin and antibiotic

Bruno Viaggi, Daniele Poole, Omar Tujjar, Silvia Marchiani, Agostino Ognibene, Stefano Finazzi
Biomarkers are widely used to confirm the presence of infection. However, it would be of the greatest importance to predict in advance the occurrence or worsening of organ dysfunction in infected patients allowing timely antibiotic escalation. This study investigates the ability of procalcitonin (PCT) and MR-proADM to predict the transition to sepsis in infected patients. The study was conducted in a neurointensive care unit over a three-month period. We included both patients with and without infection to investigate the specificity of organ dysfunction prediction in infected patients...
2018: PloS One
Thomas Waterfield, Mark D Lyttle, Derek Fairley, James Mckenna, Kerry Woolfall, Fiona Lynn, Julie-Ann Maney, Damian Roland, Aoife Weir, Michael D Shields
BACKGROUND: Children commonly present to Emergency Departments (ED) with a non-blanching rash in the context of a feverish illness. While most have a self-limiting viral illness, this combination of features potentially represents invasive serious bacterial infection, including meningococcal septicaemia. A paucity of definitive diagnostic testing creates diagnostic uncertainty for clinicians; a safe approach mandates children without invasive disease are often admitted and treated with broad-spectrum antibiotics...
July 30, 2018: BMC Pediatrics
Meret Merker, Rebekka Bolliger, Philipp Schuetz
No abstract text is available yet for this article.
August 2018: BMJ evidence-based medicine
R J Brindle, A Ijaz, P Davies
BACKGROUND: Procalcitonin levels may be raised in bacterial infections and has been used to guide antibiotic therapy. There is little data on procalcitonin and limb cellulitis. OBJECTIVES: Within a clinical trial of antibiotic therapy, we examined the correlation between clinical observations, blood tests and local measurements of skin damage, with serum procalcitonin levels. METHODS: The data is from a subset of the patients recruited into a clinical trial of antibiotic therapy for cellulitis (clindamycin for cellulitis, NCT01876628) whose procalcitonin levels were correlated with clinical and laboratory measurements...
July 27, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
Philipp Schuetz, Beat Mueller
No abstract text is available yet for this article.
July 24, 2018: JAMA: the Journal of the American Medical Association
David A Talan
No abstract text is available yet for this article.
July 24, 2018: JAMA: the Journal of the American Medical Association
Itzhak Vitkon-Barkay, Tsilia Lazarovitch, Dror Marchaim, Ronit Zaidenstein, Elizabeth Temkin, Emily T Martin, Hannah E Segaloff, Ilya Litovchik, Victoria Rum, Chana Richter, Oran Tzuman, Zvi Vered, Saar Minha
A significant proportion of patients with acute myocardial infarction (AMI) also present with clinical manifestations of inflammatory response, which may be confused with a concomitant infection. This leads to a dilemma regarding the empiric use of antibiotics. We explored if serum procalcitonin (PCT), which is known to be elevated in bacterial infections, may be utilized to rule-out bacterial infection in AMI patients. In this prospective, single center study, PCT was collected within 48hours from AMI patients...
June 2, 2018: American Journal of Cardiology
Kenneth K Sakata, Natalya Azadeh, Anjuli Brighton, M'hamed Temkit, Christine L Klassen, Thomas E Grys, Holenarasipur R Vikram
Objective: To determine whether results of the nasopharyngeal FilmArray respiratory panel (NP-FARP) influenced antibiotic decisions. Methods: We reviewed the medical records of nonintensive care unit (ICU) inpatients that had an NP-FARP performed at our institution between June 2013 and June 2014. The inpatient records were reviewed 48 hours after the NP-FARP for the following data: demographic information; NP-FARP, serum procalcitonin, and methicillin-resistant Staphylococcus aureus nasal swab (MRSA NS) results; antibiotics prior and post-48 hours of the NP-FARP result; and the current immunosuppression status...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Wen-Xia Shao, Dao-Jun Yu, Wei-Ying Zhang, Xian-Jun Wang
BACKGROUND: To discuss the clinical significance of interleukin (IL)-6 in the differential diagnosis of sepsis and its capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria. METHODS: A total of 379 children with sepsis were involved in this study to form the case group, and their C-reactive protein (CRP), procalcitonin (PCT) and IL-6 levels before antibiotics and after recovery were checked. Receiver operating characteristic curve was applied to evaluate the significance of CRP, PCT and IL-6 in the differential diagnosis of sepsis and their capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria...
August 2018: Pediatric Infectious Disease Journal
J F Xie, H B Qiu
No abstract text is available yet for this article.
July 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Derek N Bremmer, Matthew A Moffa, Kiet Ma, Holly R Bean, Joseph Snatchko, Tamara L Trienski, Courtney Watson, Thomas L Walsh
Background: Patients admitted with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often are prescribed antibiotics. Studies have shown that the use of procalcitonin (PCT) to guide the decision to initiate antibiotic therapy in AECOPD has resulted in less antibiotic use and similar outcomes compared to standard of care. We evaluated patients with AECOPD and low PCT concentrations to determine whether antibiotic therapy was associated with improved outcomes. Methods: We retrospectively evaluated adult patients admitted with AECOPD who had a peak PCT concentration <0...
July 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Andrew W Kirkpatrick, Federico Coccolini, Luca Ansaloni, Derek J Roberts, Matti Tolonen, Jessica L McKee, Ari Leppaniemi, Peter Faris, Christopher J Doig, Fausto Catena, Timothy Fabian, Craig N Jenne, Osvaldo Chiara, Paul Kubes, Braden Manns, Yoram Kluger, Gustavo P Fraga, Bruno M Pereira, Jose J Diaz, Michael Sugrue, Ernest E Moore, Jianan Ren, Chad G Ball, Raul Coimbra, Zsolt J Balogh, Fikri M Abu-Zidan, Elijah Dixon, Walter Biffl, Anthony MacLean, Ian Ball, John Drover, Paul B McBeth, Juan G Posadas-Calleja, Neil G Parry, Salomone Di Saverio, Carlos A Ordonez, Jimmy Xiao, Massimo Sartelli
Background: Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. Principles of treatment include early antibiotic administration and operative source control. A further therapeutic option may be open abdomen (OA) management with active negative peritoneal pressure therapy (ANPPT) to remove inflammatory ascites and ameliorate the systemic damage from SCIAS...
2018: World Journal of Emergency Surgery: WJES
Philipp Schuetz, Rebekka Bolliger, Meret Merker, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Charles E Luyt, Michel Wolff, Stefan Schroeder, Vandack Nobre, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Rodrigo O Deliberato, Alessia Verduri, Bianca Beghé, Bin Cao, Yahya Shehabi, Jens-Ulrik S Jensen, Albertus Beishuizen, Evelien de Jong, Matthias Briel, Tobias Welte, Beat Mueller
Although evidence indicates that use of procalcitonin to guide antibiotic decisions for the treatment of acute respiratory infections (ARI) decreases antibiotic consumption and improves clinical outcomes, algorithms used within studies had differences in PCT cut-off points and frequency of testing. We therefore analyzed studies evaluating procalcitonin-guided antibiotic therapy and propose consensus algorithms for different respiratory infection types. Areas covered: We systematically searched randomized-controlled trials (search strategy updated on February 2018) on procalcitonin-guided antibiotic therapy of ARI in adults using a pre-specified Cochrane protocol and analyzed algorithms from 32 trials that included 10,285 patients treated in primary care settings, emergency departments (ED), and intensive care units (ICU)...
July 13, 2018: Expert Review of Anti-infective Therapy
Marian S McDonagh, Kim Peterson, Kevin Winthrop, Amy Cantor, Brittany H Lazur, David I Buckley
Objective Antibiotic overuse contributes to antibiotic resistance and adverse consequences. Acute respiratory tract infections (RTIs) are the most common reason for antibiotic prescribing in primary care, but such infections often do not require antibiotics. We summarized and updated a previously performed systematic review of interventions to reduce inappropriate use of antibiotics for acute RTIs. Methods To update the review, we searched MEDLINE®, the Cochrane Library (until January 2018), and reference lists...
January 1, 2018: Journal of International Medical Research
F J Candel, M Borges Sá, S Belda, G Bou, J L Del Pozo, O Estrada, R Ferrer, J González Del Castillo, A Julián-Jiménez, I Martín-Loeches, E Maseda, M Matesanz, P Ramírez, J T Ramos, J Rello, B Suberviola, A Suárez de la Rica, P Vidal
The incidence and prevalence of sepsis depend on the definitions and records that we use and we may be underestimating their impact. Up to 60% of the cases come from the community and in 30-60% we obtain microbiological information. Sometimes its presentation is ambiguous and there may be a delay in its detection, especially in the fragile population. Procalcitonin is the most validated biomarker for bacterial sepsis and the one that best discriminates the non-infectious cause. Presepsin and pro-adrenomedullin are useful for early diagnosis, risk stratification and prognosis in septic patients...
August 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Y Wang, J Yan
No abstract text is available yet for this article.
June 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Nikolaos-Dimitrios Pantzaris, Diamantina-Xanthi Spilioti, Aikaterini Psaromyalou, Ioanna Koniari, Dimitrios Velissaris
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major complication in COPD patients which can be triggered by bacterial or viral infections, environmental pollutants and other causes. Procalcitonin (PCT), a peptide that markedly increases in cases of bacterial infection, has been extensively investigated as a biomarker in the diagnosis, prognosis and treatment in patients with AECOPD. A number of studies published in the last decade, tried to investigate whether PCT levels can differentiate between bacterial and other causes of exacerbations, if they can be used as a guide for optimal antibiotic therapy and if they can be a tool in the assessment of the severity and the need for further interventions in the management of those patients...
July 2018: Journal of Clinical Medicine Research
Yongfeng Bai, Jun Lu, Ying Cheng, Feng Zhang, Xueyu Fan, Yuanyuan Weng, Jin Zhu
For years, procalcitonin (PCT) has been employed as a diagnostic biomarker for the severity of sepsis and septic shock, as well as for guiding the application of antibiotics. However, the molecular/cellular basis for the regulation of PCT production is not fully understood. In this study, we identified the signalling pathway by which the expression of PCT was induced by lipopolysaccharide in human hepatocytes at the mRNA and protein levels. This expression was dependent on nuclear transcription factor κB (NF-κB), as indicated by a NF-κB binding site (nt -53 to -44) found in the PCT promoter region...
June 11, 2018: Scientific Reports
X Y Wang, J Zhang, L Liu, Z Ji, C Chen, J Y Yang, M Y Li
Objective: To compare and analyze the clinical characteristics and laboratory parameters of central nervous system (CNS) infection caused by different Gram-stained bacteria after craniocerebral surgery, and to provide a preliminary basis for early anti-infection treatment to reduce the use of extended-spectrum antibiotics and the generation of resistant strains. Methods: A single center retrospective study was conducted to investigate the clinical data of patients with intracranial infection after craniocerebral surgery from January 2012 to December 2016 in PLA general hospital...
May 29, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Michele Bartoletti, Massimo Antonelli, Francesco Arturo Bruno Blasi, Ivo Casagranda, Arturo Chieregato, Roberto Fumagalli, Massimo Girardis, Filippo Pieralli, Mario Plebani, Gian Maria Rossolini, Massimo Sartelli, Bruno Viaggi, Pierluigi Viale, Claudio Viscoli, Federico Pea
BACKGROUND: Procalcitonin (PCT) is a useful biomarker of bacterial infection and its use is associated to reduced duration of antibiotic therapy in the setting of intensive care medicine. To address the need of practical guidance for the use of PCT in various clinical settings, a group of experts was invited to participate at a consensus process with the aims of defining the rationale for appropriate use of PCT and for improving the management of critically ill patients with sepsis. METHODS: A group of 14 experts from anesthesiology and critical care, infectious diseases, internal medicine, pulmonology, clinical microbiology, laboratory medicine, clinical pharmacology and methodology provided expert opinion through a modified Delphi process, after a comprehensive literature review...
July 26, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
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