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Serum Procalcitonin Levels May Help Guide Antibiotic Use

Trial finds procalcitonin marker can moderate antibiotic use without increased mortality

MONDAY, Jan. 25 (HealthDay News) -- In patients with suspected severe bacterial infection, employing antibiotics judiciously based on the serum levels of the calcitonin precursor hormone procalcitonin can reduce antibiotic exposure without increased mortality, according to a study published online Jan. 23 in The Lancet.

Lila Bouadma, M.D., of the Assistance Publique-Hôpitaux de Paris, and colleagues in the PROcalcitonin to Reduce Antibiotic Treatments in Acutely ill patients trial randomized severely ill patients to either a procalcitonin group, in which antibiotics were started or stopped based on serum concentrations of procalcitonin (an indicator of infection severity), or a control group that took antibiotics according to current guidelines. The study end points were mortality at 28 and 60 days and number of days without antibiotics by day 28.

Overall, the researchers found that the procalcitonin-group mortality was non-inferior to control-group mortality at day 28 (21.2 versus 20.4 percent) and day 60 (30.0 versus 26.1 percent). In terms of antibiotic use, the patients in the procalcitonin group went significantly more days without antibiotics than patients in the control group (14.3 versus 11.6 days).

"For patients in the procalcitonin group, the absolute difference of 2.7 days between the mean numbers of days without antibiotics by day 28 corresponds to a 23 percent relative reduction in antibiotic exposure," the authors write.

Several study authors reported receiving lecture or consulting fees from pharmaceutical companies.

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