Procalcitonin-Guided Antibiotic Therapy
Conclusions (2 of 2)
There was high-strength evidence that procalcitonin guidance reduces antibiotic duration and prescription rates in patients with respiratory tract infections (including acute exacerbations of chronic obstructive pulmonary disease, community-acquired pneumonia, and acute bronchitis) in the ambulatory care or hospital setting. There was moderate-strength evidence of reduction in total antibiotic exposure in patients with respiratory tract infections in the ambulatory care or hospital setting. Absolute reduction in duration of antibiotic therapy ranged from 1 to 7 days, with relative reductions ranging from -13 to -55 percent. Absolute reduction in prescription rates ranged from -2 to -7 percent, with relative reductions ranging from -1.8 to -72 percent. There was moderate-strength evidence that procalcitonin guidance did not increase mortality, hospital length of stay, or ICU admission rates. There was insufficient evidence to judge effects on days of restricted activity or on antibiotic adverse events.
One good-quality study provided moderate-strength evidence that procalcitonin guidance reduces the use of antibiotic therapy for suspected early neonatal sepsis. The overall duration of antibiotic use was reduced by 22.4 hours (22.0%). Further, the proportion of neonates on antibiotics for longer than 72 hours was reduced by 27 percent. The strength of evidence was judged insufficient to permit conclusions on mortality and morbidity due to the small study size.
Evidence was insufficient to determine the effects of using procalcitonin-guided antibiotic therapy in children aged 1–36 months with suspected infections and in postoperative patients with suspected infections.
Keywords: antibiotic therapy | bacterial infection | procalcitonin | strength of evidence | summary | conclusions
- Soni NJ, Samson DJ, Galaydick JL, et al. Procalcitonin-Guided Antibiotic Therapy. Comparative Effectiveness Review No. 78 (Prepared by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. HHSA 290-2007-10058-I). Rockville, MD: Agency for Healthcare Research and Quality; August 2012. AHRQ Publication No. 12-EHC124-EF. Available at www.effectivehealthcare.ahrq.gov/procalcitonin.cfm.
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