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Procalcitonin Can Guide Antibiotic Use in Pneumonia

Fewer subscriptions, shorter duration of treatment does not affect outcome

MONDAY, July 3 (HealthDay News) -- Procalcitonin levels rise during bacterial infections and can be used to guide antibiotic therapy for community-acquired pneumonia, according to a report in the July issue of the American Journal of Respiratory and Critical Care Medicine.

Mirjam Christ-Crain, M.D., from University Hospital in Basel, Switzerland, and colleagues conducted a randomized intervention trial with 302 patients with suspected community-acquired pneumonia. Procalcitonin guided the initiation and duration of antibiotic therapy. For example, antibiotics were strongly discouraged with a serum procalcitonin concentration of less than 0.1 μg/L; discouraged if it was less than 0.25 μg/L; encouraged if it was greater than 0.25 μg/L; and strongly encouraged if it was greater than 0.5 μg/L.

While the outcomes were similar in both the control and test groups, patients who were treated based on their level of serum procalcitonin had reduced antibiotic exposure due to fewer subscriptions (85 percent versus 99 percent) and shorter duration of treatment (5 days versus 12 days).

"Procalcitonin guidance leads to more judicious antibiotic use, mainly by individual tailoring and earlier discontinuation of antibiotic therapy in patients with community-acquired pneumonia," the authors conclude. "These findings may have important clinical and public health implications."

"The major implication of this study is to support putting a cap on the duration of antibiotic therapy for community-acquired pneumonia, similar to that of ventilator-associated pneumonia," according to Richard Wunderink, M.D., in an accompanying editorial.

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