Effects of procalcitonin-guided treatment on antibiotic use and need for mechanical ventilation in patients with acute asthma exacerbation: Meta-analysis of randomized controlled trials

Ibrahim, Wanis H; Mushtaq, Kamran; Raza, Tasleem; Kartha, Anand; Saleh, Ahmed Osman; Malik, Rayaz A.

doi:10.1016/j.ijid.2017.10.005

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Recent original studies and meta-analyses highlighted the effectiveness of PCT protocols in early diagnosis of bacterial infection and further in assisting in the initiation and termination of antibiotic treatment [43][44][45][46][47]. Though the value of PCT in recognizing GNBSI has been explored, utility of the results in most studies is hampered by either small sample size or limited clinical information.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Lai

Wang

et al. 2020

Disease Markers

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Objective. Gram-negative bloodstream infections (GNBSIs), especially those caused by antibiotic-resistant species, have become a public health challenge. Procalcitonin (PCT) showed promising potential in early diagnosis of GNBSI; however, little was known about its performance under different clinical settings. We here systematically assessed the diagnostic accuracy of PCT in recognizing GNBSI and made direct comparisons with C-reactive protein (CRP) and interleukin 6 (IL-6). Methods. PubMed, Embase, ISI Web of Knowledge, and Scopus were searched from inception to March 15th, 2019. Area under the summary receiver operating characteristic curve (AUC), pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated. Hierarchical summary receiver operating characteristic (HSROC) model was used for the investigation of heterogeneity and for comparisons between markers. Results. 25 studies incorporating 50933 suspected BSI episodes were included. Pooled sensitivity and specificity for PCT were 0.71 and 0.76, respectively. The overall AUC was 0.80. The lowest AUCs were found in patients with febrile neutropenia (0.69) and hematological malignancy (0.69). The highest AUC was found in groups using electrochemiluminescence immunoassay (0.87). In direct comparisons, PCT showed better overall performance than CRP with the AUC being 0.85 (95% CI 0.81–0.87) for PCT and 0.78 (95% CI 0.74–0.81) for CRP, but the relative DORs varied with thresholds between PCT and CRP (p<0.001). No significant difference was found either in threshold (p=0.654) or in accuracy (p=0.480) between PCT and IL-6 in diagnosing GNBSI. Conclusions. PCT was helpful in recognizing GNBSI, but the test results should be interpreted carefully with knowledge of patients’ medical condition and should not serve as the only criterion for GNBSI. Further prospective studies are warranted for comparisons between different clinical settings.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Lai

Wang

et al. 2020

Disease Markers

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“…There are several other areas where PCT may be useful, including meningitis [ 106 , 107 ], urinary tract infections [ 108 ], chronic heart failure [ 109–111 ], and acute asthma exacerbation [ 112 ]. Overall, PCT has shown promising results, though the lack of high-quality data does not allow for decisive conclusions or recommendations yet.…”

Section: Medical Wardmentioning

confidence: 99%

Procalcitonin for individualizing antibiotic treatment: an update with a focus on COVID-19

Wolfisberg

Gregoriano

Schuetz

2021

Critical Reviews in Clinical Laboratory Sciences

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Procalcitonin (PCT) is useful for differentiating between viral and bacterial infections and for reducing the unnecessary use of antibiotics. As the rise of antimicrobial resistance reaches “alarming” levels according to the World Health Organization, the importance of using biomarkers, such as PCT to limit unnecessary antibiotic exposure has further increased. Randomized trials in patients with respiratory tract infections have shown that PCT has prognostic implications and its use, embedded in stewardship protocols, leads to reductions in the use of antibiotics in different clinical settings without compromising clinical outcomes. However, available data are heterogeneous and recent trials found no significant benefit. Still, from these trials, we have learned several key considerations for the optimal use of PCT, which depend on the clinical setting, severity of presentation, and pretest probability for bacterial infection. For patients with respiratory infections and sepsis, PCT can be used to determine whether to initiate antimicrobial therapy in low-risk settings and, together with clinical data, whether to discontinue antimicrobial therapy in certain high-risk settings. There is also increasing evidence regarding PCT-guided therapy in patients with coronavirus disease 2019 (COVID-19). This review provides an up-to-date overview of the use of PCT in different clinical settings and diseases, including a discussion about its potential to improve the care of patients with COVID-19.

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“…Table 1 shows the results of the investigated blood markers of inflammation in the studied 31 men with odontogenic abscesses of the head and neck, as well as their age. Since then, a number of studies have been carried out in which its blood concentration was investigated in many infectious diseases of bacterial origin such as sepsis and systemic inflammatory response syndrome (SIRS) [8,9], acute cardiovascular pathology [10], endocarditis [11], bacterial pneumonia and other acute respiratory infections [12], exacerbated chronic obstructive pulmonary disease (COPD) [13], exacerbated bronchial asthma [14], acute bacterial meningitis [15], acute appendicitis [16,17], acute necrosis of intestine [18], pyelonephritis [19] and acute and chronic hepatitis [20]. In all these diseases, the authors accept PCT reference values from 0.0 to 0.5 ng/ml.…”

Section: Resultsmentioning

confidence: 99%

Procalcitonin as a New Inflammatory Marker in Odontogenic Abscesses of Head and Neck in Male Population

Yankov,

Bocheva

2024

JofIMAB

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Introduction: Procalcitonin (PCT) as a marker of inflammation has not been studied and analyzed in purulent inflammations of the head and neck of odontogenic origin, which is the aim of this original article. Materials and methods: This retrospective study includes 31 men with odontogenic abscesses of the head and neck with a mean age of 42 years. As a control group, 31 healthy men are used. In all of them, leukocytes (WBC), neutrophils (Neu), C-reactive protein (CRP), and procalcitonin (PCT) are tested. Results: The average values of the studied indicators in the patients are: CRP - 89.45±85.15 mg/l, WBC - 11.78±4.61x103/L, Neu - 8.79±4.58x103/L and PCT - 0.8±0.8 ng/ Jr. The average values of the same indicators in the control group are: CRP - 0.9±1.17 mg/l, WBC - 7.37±1.9x103/L, Neu - 4.13±1.43x103/L and PCT - 0.18±1.27 ng/ml. There is no positive correlation between PCT on the one hand and CRP, WBC and Neu on the other hand. Discussion: The mean values of CRP, WBC, Neu and PCT are higher in men with odontogenic abscesses compared to the healthy controls, and this is statistically significant. Although PCT does not correspond to WBC, Neu and CRP, it has a number of advantages over them - it increases its concentration only in infections of bacterial origin, it increases its levels earlier and reaches its highest concentration earlier, it has a longer half-life, and its level declines more rapidly after infections. Conclusions: All this suggests that PTC may soon become the most accurate marker in diagnosing, treating, and follow-up of patients with head and neck odontogenic abscesses.

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Effects of procalcitonin-guided treatment on antibiotic use and need for mechanical ventilation in patients with acute asthma exacerbation: Meta-analysis of randomized controlled trials

Abstract: These data suggest a potential benefit for the use of serum procalcitonin in guiding antibiotic therapy in patients with an acute asthma exacerbation and advocates the need for more randomized controlled trials.

Cited by 5 publications

References 34 publications

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Procalcitonin for individualizing antibiotic treatment: an update with a focus on COVID-19

Procalcitonin as a New Inflammatory Marker in Odontogenic Abscesses of Head and Neck in Male Population

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