Duration of pneumonia therapy and the role of biomarkers

Kaziani, Katerina; Sotiriou, Adamantia; Dimοpoulos, George

doi:10.1097/qco.0000000000000351

Cited by 14 publications

(12 citation statements)

References 21 publications

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“…Although far from being ideal, PCT is one of the most well-studied biomarkers in RCTs including over 7000 patients suffering with all types of LRTIs, at all treatment settings. It has been proved to have a more favourable kinetic profile and to be more sensitive and specific than other biomarkers, such as IL-6, C reactive protein (CRP) and lactate 31,32 ; it demonstrates a mean sensitivity of 94.1% and specificity of 88.4% for the diagnosis of LRTIs 33 with a negative predictive value to rule out LRTIs to be Figure 1. The physiological pathway of calcitonin (CT) takes place in the thyroid C cells.…”

Section: Diagnostic Value Of Procalcitoninmentioning

confidence: 99%

“…Even though the use of PCT in guiding antibiotic initiation may be disputed, it is successfully assessed as part of antibiotic discontinuation protocols 32 . Zhang et al 54 (2015) reviewed 43 antibiotic stewardship programs (ASPs) related studies, in eight of which PCT-guided antibiotic protocols were used 54 .…”

Section: Prognostic Value Of Procalcitoninmentioning

confidence: 99%

“…past 32 . De Jong et al 22 conclude that the cost of serial PCT measurements is outweighed by the reduction in the consumption of antibiotics, without beneficial effects on ICU and hospital stay duration, antimicrobial-related adverse events and antimicrobial resistance.…”

Section: Pct As a Determinant For Antibiotic Therapy Initiation And Dmentioning

confidence: 99%

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The Case of Procalcitonin for Lower Respiratory Tract Infections

Karakioulaki¹,

Stolz²

2021

BRN

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Lower respiratory tract infections (LRTIs) contribute significantly to the morbidity and mortality among all age groups. Antibiotics can effectively treat LRTIs due to bacterial infection. Unfortunately, they are commonly prescribed even when the cause of the infection is non-bacterial, leading to an increase in antimicrobial resistance, mortality and health costs. This review aims to highlight the importance of procalcitonin (PCT) for the diagnosis of bacterial LRTIs. We conclude that PCT serum levels can help clinicians establish the need for antibiotics and individualise the duration of treatment in LRTIs. In addition, serum PCT provide prognostic information about the severity of the disease. However, PCT serum levels cannot inform decisions on a stand-alone fashion and should not be expected to substitute a thorough history and physical examination. (BRN Rev. 2019;5(4):277-93)

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Section: Diagnostic Value Of Procalcitoninmentioning

confidence: 99%

Section: Prognostic Value Of Procalcitoninmentioning

confidence: 99%

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The Case of Procalcitonin for Lower Respiratory Tract Infections

Karakioulaki¹,

Stolz²

2021

BRN

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“…However, other studies and reviews have supported shorter duration of antibiotic therapy in patients with CAP and suggested that the use of biomarkers, such as PCT, may be useful in guiding both the initiation and the duration of antibiotic treatment 48 , 49 . One group of investigators documented that an implementation strategy, tailored to identify previous barriers to early switch, was associated with a reduced duration of intravenous therapy 50 .…”

Section: Antibiotic Treatment Of Community-acquired Pneumoniamentioning

confidence: 99%

Appropriate antibiotic management of bacterial lower respiratory tract infections

Feldman

Richards

2018

F1000Res

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Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of treatment for the most important bacterial lower respiratory tract infections, namely acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP), is the use of antibiotics. Yet despite a number of recent publications, including clinical studies as well as several systematic literature reviews and meta-analyses, there is considerable ongoing controversy as to what the most appropriate antibiotics are for the empiric therapy of CAP in the different settings (outpatient, inpatient, and intensive care unit). Furthermore, in the case of AECOPD, there is a need for consideration of which of these exacerbations actually need antibiotic treatment. This article describes these issues and makes suggestions for appropriately managing these conditions, in the setting of the need for antimicrobial stewardship initiatives designed to slow current emerging rates of antibiotic resistance, while improving patient outcomes.

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“…В последнее время с целью определения оптимальной длительности АБТ внебольничных инфекций нижних дыхательных путей, в т. ч. и ВП, наряду с учетом динамики соответствующих клинических симптомов заболевания, стали использоваться и биомаркеры (прежде всего прокальцитонин -ПКТ) [51]. При этом разработан своеобразный алгоритм, ориентируясь на который, врачу предлагается либо продолжить лечение, либо прекратить дальнейшее назначение антибиотиков (рис.…”

Section: биомаркеры и длительность антибактериальной терапии больных unclassified

Short antibiotic courses in community-acquired pneumonia in adults: less is better

Синопальников¹

2018

Med. sov.

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Несмотря на достигнутые успехи в диагностике, терапии и профилактике инфекций дыхательных путей, внебольничная пневмония (ВП) остается достаточно распространенным заболеванием [1-3], сохраняя статус ведущей инфекционной причины смерти современного человека и унося ежегодно больше жизней, чем туберкулез, менингит, СПИД и инфекционный эндокардит вместе взятые [4]. При этом, очевидно, наиболее действенным инструментом в достижении лучшего исхода ВП являются клинические рекомендации, декларирующие в т. ч. и подходы к рациональной эмпирической антибактериальной терапии (АБТ) заболевания [5-8]. Однако вопрос об определении оптимальной продолжительности АБТ остается предметом оживленных дискуссий (табл. 1). Здесь важно отметить, что в большинстве случаев клинической стабильности больных ВП удается добиться уже в первые 3-5 дней эмпирической АБТ, и редко когда возникает необходимость в продолжительном назначении антибиотиков [12].

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Duration of pneumonia therapy and the role of biomarkers

Cited by 14 publications

References 21 publications

The Case of Procalcitonin for Lower Respiratory Tract Infections

The Case of Procalcitonin for Lower Respiratory Tract Infections

Appropriate antibiotic management of bacterial lower respiratory tract infections

Short antibiotic courses in community-acquired pneumonia in adults: less is better

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