Effect of Procalcitonin-Guided Treatment in Patients with Infections: a Systematic Review and Meta-Analysis

Tang, Hongmei; Huang, Tao; Jing, Jibo; Shen, Haixiang; Cui, Wenyan

doi:10.1007/s15010-009-9034-2

Cited by 98 publications

(69 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The measurement of a series of PCT levels has consistently been described as useful for the evaluation of therapeutic success [7,21]. Hohn et al demonstrated these effects, even among routine clinical populations [22].…”

Section: Discussionmentioning

confidence: 99%

“…PCT Reduction: PCT reduction within 12 days of the first pathological PCT measurement PCT reduction was considered to have occurred when the PCT value was 80% lower than the highest value recorded, or 0.25 ng/ml; these definitions have been used in various scientific publications and ensure practical limits to evaluate the effect of an antibiotic [7,11].…”

Section: Episodementioning

confidence: 99%

“…For example, PCT levels differentiate more effectively between sepsis and systemic inflammatory response syndrome (SIRS) than those of IL-6, IL-8, or CRP [5,6]. A meta-analysis of several clinical studies of various infections demonstrated that PCTguided antibiotic therapy reduced both therapy duration and the length of stay in intensive care [7]. Based on this broad evidence, another meta-analysis focused on sepsis was conducted, the results of which indicated that antibiotic therapy can be curtailed by a mean of four days, and length of ICU stay reduced by a mean of 1.8 days.…”

Section: Introduction and Objectivesmentioning

confidence: 99%

See 2 more Smart Citations

Procalcitonin: a valuable markerfor assessment of the success of antimicrobial therapy for severe sepsis An analysis using routine clinical data

Wilke

2016

MRAJ

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Episodementioning

confidence: 99%

Section: Introduction and Objectivesmentioning

confidence: 99%

See 1 more Smart Citation

Procalcitonin: a valuable markerfor assessment of the success of antimicrobial therapy for severe sepsis An analysis using routine clinical data

Wilke

2016

MRAJ

View full text Add to dashboard Cite

“…However, other authors reported lower diagnostic accuracy, with sensitivity as low as 41% (22) and specificity as low as 24% (23). PCT could be an interesting tool to discontinue antimicrobial therapy safely in the ICU according to recent studies (24,25), and as such could represent a potential candidate as a POCT tool. POCT to laboratory testing correlation seems to be sufficient (26), but there is no available data regarding its use for VAP, and few results are available for communityacquired pneumonia (27).…”

Section: Introductionmentioning

confidence: 99%

The next generation of rapid point-of-care testing identification tools for ventilator-associated pneumonia

Millot¹,

Voisin²,

Loïez³

et al. 2017

Ann. Transl. Med.

View full text Add to dashboard Cite

Ventilator-associated pneumonia (VAP) is a frequent issue in intensive care units (ICU), with a major impact on morbidity, mortality and cost of care. VAP diagnosis remains challenging: traditional culture-based microbiological techniques are still the gold-standard, but are too slow to enable clinicians to improve prognosis with timely antimicrobial therapy adjustment. Prolonged exposure to inappropriate antibiotics has also been shown to increase the incidence of multi-drug-resistant organisms (MDROs).Point-of-care testing (POCT) tools are diagnostic testing methods that can be used at or near the bedside, with delays ranging from a couple minutes to a few hours. The use of POCTs for VAP could allow for faster diagnosis and antimicrobial therapy adjustments. Despite uncertainty regarding their diagnostic value, C-reactive protein (CRP) and procalcitonin (PCT) can be detected using POCTs in few minutes. In VAP, CRP showed a sensitivity of 56% to 88% and specificity of 86% to 91%; PCT showed a sensitivity of 78% to 100% and a specificity between 75% and 97% using non-POCT methods. Automated microscopy could also be used in clinical ICU setting, with reported sensitivity of 100% and specificity of 97%, allowing for antibiotic susceptibility testing (AST) in less than 12 h. Multiplex polymerase chain reaction (MPCR) could allow for identification and AST approximation through the detection of drug-resistance genes in about 6 h, with reported sensitivity of 89.2% and specificity of 97.1%; although use as POCT was shown to result in test failure in about 40% of samples. Despite being at an early development stage, exhalome analysis, which allows for non-invasive fast identification, and chromogenic tests, more suited for the detection of drugresistance enzymes, are also promising techniques for POCT diagnosis of VAP.

show abstract

“…The use of PCT supplies caregivers with added information, which, in principle, enables them to improve the selection of patients for treatment, the timing of treatment initiation, and the overall duration of treatment [21,28,32,33,35,[41][42][43][44][45][46][47]. Insofar as caregivers change their care management and treatment strategies in response to the new information (relative to the usual standard course of action), there are implications for changes in outcomes, both in terms of treatment costs and health status [14,33,35].…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective

Schuetz

Balk

Briel³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

Background: Whether or not antibiotic stewardship protocols based on procalcitonin levels results in cost savings remains unclear. Herein, our objective was to assess the economic impact of adopting procalcitonin testing among patients with suspected acute respiratory tract infection (ARI) from the perspective of a typical US integrated delivery network (IDN) with a 1,000,000 member catchment area or enrollment. Methods: To conduct an economic evaluation of procalcitonin testing versus usual care we built a cost-impact

show abstract

Effect of Procalcitonin-Guided Treatment in Patients with Infections: a Systematic Review and Meta-Analysis

Cited by 98 publications

References 42 publications

Procalcitonin: a valuable markerfor assessment of the success of antimicrobial therapy for severe sepsis An analysis using routine clinical data

Procalcitonin: a valuable markerfor assessment of the success of antimicrobial therapy for severe sepsis An analysis using routine clinical data

The next generation of rapid point-of-care testing identification tools for ventilator-associated pneumonia

Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective

Contact Info

Product

Resources

About