Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study

BACKGROUND: Procalcitonin, a biomarker to adjudge the duration of antibiotic therapy in patients with sepsis. MATERIALS AND METHODS: A prospective, randomized, controlled, interventional, single-center study was conducted in a mixed adult intensive care unit (ICU). In a nonblinded study, 90 adult pa...

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Autores principales: Vishalashi, SM Gowri, Gupta, Poonam, Verma, Pardeep Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196370/
https://www.ncbi.nlm.nih.gov/pubmed/34177168
http://dx.doi.org/10.5005/jp-journals-10071-23802
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author Vishalashi, SM Gowri
Gupta, Poonam
Verma, Pardeep Kumar
author_facet Vishalashi, SM Gowri
Gupta, Poonam
Verma, Pardeep Kumar
author_sort Vishalashi, SM Gowri
collection PubMed
description BACKGROUND: Procalcitonin, a biomarker to adjudge the duration of antibiotic therapy in patients with sepsis. MATERIALS AND METHODS: A prospective, randomized, controlled, interventional, single-center study was conducted in a mixed adult intensive care unit (ICU). In a nonblinded study, 90 adult patients admitted to the ICU with sepsis and septic shock were randomized into group P (group procalcitonin) and group C (group control). The duration of antibiotic therapy was decided based on serum procalcitonin levels for patients in group P versus standard treatment protocols in group C. A procalcitonin value of <0.01 ng/mL or a subsequent decline of >80% from the baseline was cutoff and chosen to stop the antibiotic therapy. The primary aim was to compare the duration of antibiotic therapy (in days) in the two groups. The secondary objective was to compare and assess the length of ICU stay, reinfection, secondary infection rate, readmission rate, and mortality among the groups. RESULTS: The mean duration of antibiotic therapy was significantly lesser in patients in group P (4.98 ± 2.56 vs 7.73 ± 3.06 days, p < 0.001). Patients in group C spent more days in ICU (8.80 ± 3.35 vs 5.98 ± 2.73 days, p < 0.001). The secondary infection rate was significantly higher in group C (26.7% vs 4.4%, p = 0.014). Readmission and mortality rates were comparable between the groups. CONCLUSION: Serum procalcitonin-based algorithm in critically ill patients with sepsis could lead to a reduction in the duration of antibiotic therapy, ICU stay, and associated morbidities like secondary infection rates. It further promotes antibiotic stewardship without any adverse effects on the patient's outcome. HOW TO CITE THIS ARTICLE: Vishalashi SMG, Gupta P, Verma PK. Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study. Indian J Crit Care Med 2021;25(5):507–511.
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spelling pubmed-81963702021-06-24 Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study Vishalashi, SM Gowri Gupta, Poonam Verma, Pardeep Kumar Indian J Crit Care Med Original Research BACKGROUND: Procalcitonin, a biomarker to adjudge the duration of antibiotic therapy in patients with sepsis. MATERIALS AND METHODS: A prospective, randomized, controlled, interventional, single-center study was conducted in a mixed adult intensive care unit (ICU). In a nonblinded study, 90 adult patients admitted to the ICU with sepsis and septic shock were randomized into group P (group procalcitonin) and group C (group control). The duration of antibiotic therapy was decided based on serum procalcitonin levels for patients in group P versus standard treatment protocols in group C. A procalcitonin value of <0.01 ng/mL or a subsequent decline of >80% from the baseline was cutoff and chosen to stop the antibiotic therapy. The primary aim was to compare the duration of antibiotic therapy (in days) in the two groups. The secondary objective was to compare and assess the length of ICU stay, reinfection, secondary infection rate, readmission rate, and mortality among the groups. RESULTS: The mean duration of antibiotic therapy was significantly lesser in patients in group P (4.98 ± 2.56 vs 7.73 ± 3.06 days, p < 0.001). Patients in group C spent more days in ICU (8.80 ± 3.35 vs 5.98 ± 2.73 days, p < 0.001). The secondary infection rate was significantly higher in group C (26.7% vs 4.4%, p = 0.014). Readmission and mortality rates were comparable between the groups. CONCLUSION: Serum procalcitonin-based algorithm in critically ill patients with sepsis could lead to a reduction in the duration of antibiotic therapy, ICU stay, and associated morbidities like secondary infection rates. It further promotes antibiotic stewardship without any adverse effects on the patient's outcome. HOW TO CITE THIS ARTICLE: Vishalashi SMG, Gupta P, Verma PK. Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study. Indian J Crit Care Med 2021;25(5):507–511. Jaypee Brothers Medical Publishers 2021-05 /pmc/articles/PMC8196370/ /pubmed/34177168 http://dx.doi.org/10.5005/jp-journals-10071-23802 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Vishalashi, SM Gowri
Gupta, Poonam
Verma, Pardeep Kumar
Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study
title Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study
title_full Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study
title_fullStr Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study
title_full_unstemmed Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study
title_short Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units: A Prospective Study
title_sort serum procalcitonin as a biomarker to determine the duration of antibiotic therapy in adult patients with sepsis and septic shock in intensive care units: a prospective study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196370/
https://www.ncbi.nlm.nih.gov/pubmed/34177168
http://dx.doi.org/10.5005/jp-journals-10071-23802
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