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Procalcitonin-Guided Antibiotic Therapy

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Effects of Using Procalcitonin To Guide Antibiotic Therapy in Postoperative Patients

Evidence was insufficient to determine if procalcitonin guidance can identify postoperative patients at risk of developing infections who might benefit from pre-emptive antibiotic therapy. A single study evaluated outcomes in 20 postoperative patients with elevated procalcitonin levels who were randomized to receive either prophylactic or pre-emptive antibiotic therapy or standard care (control). Procalcitonin-guided pre-emptive antibiotic therapy reduced the duration of antibiotic therapy by 3.5 days when compared with the control arm; however, this difference was not statistically significant. Patients in the control arm had a significantly prolonged hospital length of stay (12 days longer; P = 0.057) and a significantly higher incidence of systemic infection (P = 0.07). However, due to small size of the study, the strength of evidence for this finding was rated insufficient.