Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns)

Schuerman, Frank A B A; Groot, Rita K van den Tooren-de; Wieringa, Jantien W; Meer-Kappelle, Laura H van der; Sie, Sintha D.; Schlapbach, Luregn J.; Mol, Arjen; Hoffman-Haringsma, Angelique; Visser, Eline G.; Bakry, Ahmed K.; Dutta, Sourabh; Helou, Salhab el; Kalaniti, Kaarthigeyan; Pogorzelski, David; Alliston, S; Roy, Madan; Grey, Vijaylaxmi; K, Hauff; Hill, S. L.; Kittanakom, Saranya; Janota, J; Višňovská, Magda; Fontana, Matteo; Lanz, N; Stocker, Martin; Glauser, D; Zimmerman, Urs; Tomaske, Maren; Nelle, Mathias; Schlapbach, LJ; Schuerman, Faba; Sie, SD; Weissenbruch, Mirjam M. van; Dungen, Fam van den; Strik, Marc; Tooren-de, HK van den; Rossum, Groot A van; Batstra, Manou R.; Meer-Kappelle, LH van der; Vries, Esther de; Mol, AC de; Bolt-Wieringa, J; Stok, D; Moonen, Rob; Donker, Sarah; Gijsel, Juliette van; Gondriet, Ipe; Herk, Wendy van; Hoekstein, S; Hofhuis, M; Hop, Wcj; Ligt, L de; Manai, B; Kornelisse, René F.; Rijke, YB de; Rossum, Annemarie M. C. van; Siiskonen, Satu J.; Velden, Jolanda van der; Visser, E; Wijk, J Asch van; Willemsen, Sten P.; Geijn, GJ van der; Haringsma, Angelique; Andriessen, Peter; Broeren, Mac; Donker, Albertine E.

doi:10.1016/s0140-6736(17)31444-7

Cited by 221 publications

(198 citation statements)

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“…In normal birth weight infants, a PCT level greater than 0.5 ng/mL is associated with a nosocomial infection, whereas a level of greater than 2.4 ng/mL in VLBW infants should prompt antibiotic therapy [39]. It has been shown that procalcitonin-guided decision making is superior to standard care in reducing antibiotic therapy in neonates with suspected EONS [40]. PCT levels, however, can be elevated with noninfectious conditions such as respiratory distress syndrome, pneumothorax, intracranial hemorrhage, and hemodynamic instability [41].…”

Section: Diagnostic Testingmentioning

confidence: 99%

Neonatal Sepsis

Ershad

Mostafa

Cruz

et al. 2019

Curr Emerg Hosp Med Rep

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Section: Diagnostic Testingmentioning

confidence: 99%

Neonatal Sepsis

Ershad

Mostafa

Cruz

et al. 2019

Curr Emerg Hosp Med Rep

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“…A recent meta-analysis confirms that PCT can be a feasible biomarker for the reduction of consumption and duration of antibiotics for septic patients (7). This has also been shown in newborns with early-onset sepsis (8). One of the strengths of using PCT is that it seems to be a useful tool to guide and monitor antibiotic therapy.…”

mentioning

confidence: 91%

Procalcitonin; a feasible biomarker for severe bacterial infections in Obstetrics and Gynecology?

Tujula

Kokki

Räsänen

et al. 2018

Acta Obstet Gynecol Scand

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“…In adults with severe infections and sepsis, procalcitonin has been shown to successfully guide de-escalation [126][127][128][129][130] with an associated improved mortality [131]. Similar reductions in length of antimicrobial therapy have also been safely achieved in neonatal populations [132] using procalcitonin as a guide. In the United Kingdom, the NICE committee concluded that in emergency department and critical care settings, procalcitonin testing shows promise, but currently, insufficient evidence is available to recommend the routine adoption of procalcitonin-guided antimicrobial de-escalation (www.nice.org.…”

mentioning

confidence: 95%

Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children

et al. 2020

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Objectives: To develop evidence-based recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with septic shock and other sepsis-associated organ dysfunction.Design: A panel of 49 international experts, representing 12 international organizations, as well as three methodologists and three public members was convened. Panel members assembled at key international meetings (for those The Society of Critical Care Medicine guidelines are intended for general information only, are not medical advice, and do not replace professional advice, which should be sought for any medical condition. The full disclaimer for guidelines can be accessed at https ://www.sccm.org/Resea rch/Guide lines /Guide lines . panel members attending the conference), and a stand-alone meeting was held for all panel members in November 2018. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and group heads, as well as within subgroups, served as an integral part of the guideline development process. Methods:The panel consisted of six subgroups: recognition and management of infection, hemodynamics and resuscitation, ventilation, endocrine and metabolic therapies, adjunctive therapies, and research priorities. We conducted a systematic review for each Population, Intervention, Control, and Outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak, or as a best practice statement. In addition, "in our practice" statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate. Results:The panel provided 77 statements on the management and resuscitation of children with septic shock and other sepsis-associated organ dysfunction. Overall, six were strong recommendations, 49 were weak recommendations, and nine were best-practice statements. For 13 questions, no recommendations could be made; but, for 10 of these, "in our practice" statements were provided. In addition, 52 research priorities were identified. Conclusions:A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations. Despite this challenge, these recommendations regarding the management of children with septic shock and other sepsis-associated organ dysfunction provide a foundation for consistent care to improve outcomes and inform future research. S14 the group heads, panel members, and methodologists. Searches utilized ...

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Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns)

Cited by 221 publications

References 38 publications

Neonatal Sepsis

Neonatal Sepsis

Procalcitonin; a feasible biomarker for severe bacterial infections in Obstetrics and Gynecology?

Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children

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