Point-of-care procalcitonin guidance to reduce antibiotic use in critically ill patients: a randomized controlled trial

Wan Muhd Shukeri, Wan Fadzlina and Md Ralib, Azrina and Mat Nor, Mohd Basri (2018) Point-of-care procalcitonin guidance to reduce antibiotic use in critically ill patients: a randomized controlled trial. IIUM Medical Journal Malaysia, 17 (Supp 1). p. 26. ISSN 1823-4631

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Abstract

Introduction: Antibiotic therapy is of great importance in sepsis but prolonged duration can add to the emergence of antibiotic resistance. We aimed to examine whether point-of-care (POC) procalcitonin (PCT) guidance can safely reduce the duration of antibiotic use in infected critically ill patients. Materials and Methods: Eighty adult patients admitted to or acquired sepsis in the intensive care unit (ICU) were enrolled in this randomized controlled trial. Patients were allocated to either POC PCT-guided intervention arm (n=40) or the control arm, in which antibiotic therapy followed local guidelines (n=40). In the PCT-guided arm, antibiotic treatment was discontinued if clinical signs of infection improved and the PCT concentration decreased by >80% of its peak value, or when it reaches a value of <0·5 g/L. Results: The mean duration of antibiotic use for PCT arm was 6.4 (SD 2.3) days compared to 9 (SD 4.3) days in the control arm (p=0.004). In the first 30 days after being assigned to a group, the proportion of patients who received a repeated course of systemic antibiotics was 33% in the PCT arm vs 38.1% in the control arm (p=0.757). Mean length of stay in the ICU was 8.4 (SD 5.3) days in the PCT arm vs 10.4 (SD 12.3) days in the control arm (p=0.404). Mortality at 30 days was 22.5% in the PCT-arm vs 25% in the control arm (p<0.0001). Conclusion: POC PCT guidance stimulates reduction of duration of antibiotic use in ICU, accompanied by a significant decrease in mortality

Item Type:	Article (Meeting Abstract)
Additional Information:	5608/82593
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	02 Sep 2020 14:27
Last Modified:	02 Sep 2020 14:27
URI:	http://irep.iium.edu.my/id/eprint/82593

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