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Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial

BACKGROUND: This study was conducted to assess the efficacy of point-of-care (POC) procalcitonin (PCT) serial measurement in determining the antibiotic treatment duration in patients with ventilator-associated pneumonia (VAP). METHODS: One hundred patients were randomly recruited and then further ra...

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Autores principales: Mazlan, Mohd Z., Ismail, Mohd A.H., Ali, Saedah, Salmuna, Zeti N., Shukeri, Wan F. Wan Muhd, Omar, Mahamarowi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158486/
https://www.ncbi.nlm.nih.gov/pubmed/34006044
http://dx.doi.org/10.5114/ait.2021.104300
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author Mazlan, Mohd Z.
Ismail, Mohd A.H.
Ali, Saedah
Salmuna, Zeti N.
Shukeri, Wan F. Wan Muhd
Omar, Mahamarowi
author_facet Mazlan, Mohd Z.
Ismail, Mohd A.H.
Ali, Saedah
Salmuna, Zeti N.
Shukeri, Wan F. Wan Muhd
Omar, Mahamarowi
author_sort Mazlan, Mohd Z.
collection PubMed
description BACKGROUND: This study was conducted to assess the efficacy of point-of-care (POC) procalcitonin (PCT) serial measurement in determining the antibiotic treatment duration in patients with ventilator-associated pneumonia (VAP). METHODS: One hundred patients were randomly recruited and then further randomly divided into two groups of 50 patients each. The first group used the POC PCT test along with the standard sepsis parameter monitoring, while the second group had the standard monitoring only (C-reactive protein [CRP] level, total white count, temperature and tracheal aspirate culture). Serial PCT test results and CRP levels were monitored on days 1, 3, 7 and 9. The patients were followed up for 28-day mortality. RESULTS: Eighty-five patients completed the trial, of whom 43 were in the PCT group and 42 were in the control group. The PCT group had a significantly lower mean (SD) antibiotic treatment duration (10.28 [2.68] days) than the control group (11.52 [3.06]). The mean (SD) difference was −1.25 (95% confidence interval [CI], −2.48 to 0.01; t-statistic [df] = −1.997 [83]; P = 0.049). The PCT group also had a higher number of antibiotic-free days alive during the 28 days after VAP onset than the control group (mean [SD], 10.79 [7.61] vs. 8.72 [6.41]). The Sequential Organ Failure Assessment score was the sole factor for the decrease in duration after VAP onset (regression coefficient b [95% CI], −0.70 [−1.19 to −0.20]; P = 0.006). CONCLUSIONS: The POC procalcitonin test can reduce the antibiotic treatment duration in patients with VAP.
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spelling pubmed-101584862023-05-17 Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial Mazlan, Mohd Z. Ismail, Mohd A.H. Ali, Saedah Salmuna, Zeti N. Shukeri, Wan F. Wan Muhd Omar, Mahamarowi Anaesthesiol Intensive Ther Original and Clinical Articles BACKGROUND: This study was conducted to assess the efficacy of point-of-care (POC) procalcitonin (PCT) serial measurement in determining the antibiotic treatment duration in patients with ventilator-associated pneumonia (VAP). METHODS: One hundred patients were randomly recruited and then further randomly divided into two groups of 50 patients each. The first group used the POC PCT test along with the standard sepsis parameter monitoring, while the second group had the standard monitoring only (C-reactive protein [CRP] level, total white count, temperature and tracheal aspirate culture). Serial PCT test results and CRP levels were monitored on days 1, 3, 7 and 9. The patients were followed up for 28-day mortality. RESULTS: Eighty-five patients completed the trial, of whom 43 were in the PCT group and 42 were in the control group. The PCT group had a significantly lower mean (SD) antibiotic treatment duration (10.28 [2.68] days) than the control group (11.52 [3.06]). The mean (SD) difference was −1.25 (95% confidence interval [CI], −2.48 to 0.01; t-statistic [df] = −1.997 [83]; P = 0.049). The PCT group also had a higher number of antibiotic-free days alive during the 28 days after VAP onset than the control group (mean [SD], 10.79 [7.61] vs. 8.72 [6.41]). The Sequential Organ Failure Assessment score was the sole factor for the decrease in duration after VAP onset (regression coefficient b [95% CI], −0.70 [−1.19 to −0.20]; P = 0.006). CONCLUSIONS: The POC procalcitonin test can reduce the antibiotic treatment duration in patients with VAP. Termedia Publishing House 2021-04-12 2021-08 /pmc/articles/PMC10158486/ /pubmed/34006044 http://dx.doi.org/10.5114/ait.2021.104300 Text en Copyright © Polish Society of Anaesthesiology and Intensive Therapy https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/) ), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original and Clinical Articles
Mazlan, Mohd Z.
Ismail, Mohd A.H.
Ali, Saedah
Salmuna, Zeti N.
Shukeri, Wan F. Wan Muhd
Omar, Mahamarowi
Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
title Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
title_full Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
title_fullStr Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
title_full_unstemmed Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
title_short Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
title_sort efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
topic Original and Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158486/
https://www.ncbi.nlm.nih.gov/pubmed/34006044
http://dx.doi.org/10.5114/ait.2021.104300
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