Bacterial infections, acute and severe: Procalcitonin for diagnosis and guidance of antibiotics
DISEASE INTERVENTION COMPARISON RESULTS
Chest. 2007 Jan;131(1):9-19 Randomized Controlled Trial
IN chronic obstructive pulmonary disease, exacerbations, respiratory infection, lower airways The Use of
procalcitonin, treating with antibiotics according to serum procalcitonin levels
As Diagnostic Tool
Is better Than
systematic treatment with antibiotics
To identify patients with active respiratory infection and guide antibiotic use: it reduced antibiotic use (40% vs 72%) obtaining same clinical outcome at 14 days and rehospitalzation rate (21% vs 24%)
Am J Respir Crit Care Med. 2006 Jul 1;174(1):84-93. Epub 2006 Apr 7 Study type to be defined
IN pneumonia, community-adquired, respiratory infection, lower airways The Use of
procalcitonin, antibiotics use according to procalcitonin (in mug/L): strongly discouraged < 0.1; discouraged < 0.25; encouraged > 0.25; strongly encouraged > 0.5
As Diagnostic Tool
Is better Than
systematic treatment with antibiotics
To identify patients with severe infection and guide antibiotic use: it reduced antibiotic use (85% vs 99%) and duration (5 vs 12 days) obtaining same outcome (success rate 83%)
Lancet. 2010 Feb 6;375(9713):463-74 Randomized Controlled Trial, Multicenter Study
IN sepsis, any bacterial infection, critically ill patients The Use of
procalcitonin, treating with antibiotics according to serum procalcitonin levels
As Diagnostic Tool
Is equal Than
empirical treatment with antibiotics according with guidelines
To modify mortality at 60 days (30% procalcitonine VS 26% standard care, p=NS) while increasing the number of days without antibiotic (14 days procalcitonine VS 11.6 days standard care)
Lancet Infect Dis. 2007 Mar;7(3):210-7 Systematic Review
IN sepsis, critically ill patients The Use of
procalcitonin
As Diagnostic Tool
Is bad Than
no comparison here
To accurately differentiate sepsis from other non-infectious causes of systemic inflammatory response: both sensibility and specificity 71%