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Procalcitonin-Guided Antibiotic Therapy

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Procalcitonin-Guided Antibiotic Therapy

This slide set is based on a comparative effectiveness review (CER), Procalcitonin-Guided Antibiotic Therapy, Comparative Effectiveness Review No. 78, which was developed by the Blue Cross Blue Shield Association Technology Evaluation Center Evidence-based Practice Center, Chicago, IL, for the Agency for Healthcare Research and Quality (AHRQ) under Contract No. HHSA 290-2007-10058-I and is available online at www.effectivehealthcare.ahrq.gov/procalcitonin.cfm.

CERs are comprehensive systematic reviews of the literature. For this CER, the existing body of evidence on the effects of using procalcitonin for guiding antibiotic therapy was reviewed. The literature included in this review was identified in searches for studies in the MEDLINE®, EMBASE®, Cochrane Database of Systematic Reviews, National Institute for Clinical Excellence, the National Guideline Clearinghouse, and the Health Technology Assessment Programme databases using relevant search terms. This systematic review included 18 studies that compared procalcitonin-guided versus clinical criteria-guided initiation, discontinuation, or change of antibiotic therapy in over 6,000 patients (including critically ill adults and pediatric patients with suspected infection and patients with respiratory tract infections). Only randomized controlled trials and nonrandomized studies were included. Outcomes were antibiotic usage, mortality, morbidity, adverse drug events of antibiotic therapy, and hospital or intensive care unit length of stay. Searches were conducted for studies published in the English language between January 1, 1990, and December 16, 2011.