PMID: 22338468Feb 18, 2012Paper

Procalcitonin-based therapeutic strategy to reduce antibiotic use in patients after cardiac surgery: a randomized controlled trial

Srpski arhiv za celokupno lekarstvo
Vera Maravić-StojkovićJelena Marinković

Abstract

Procalcitonin (PCT) is a thyroid gland prohormone, and its serum concentration is elevated in systemic bacterial infections. The diagnostic cut-off value of PCT in patients early after cardiac surgery remains unclear. We investigated whether procalcitonin-guidance could reduce antibiotic usage safely. The prospective study included 205 patients who underwent open heart surgery. The patients were randomly assigned for procalcitonin-guided antibiotic treatment (PCT-group; n = 102) or standard care (standard group; n = 103). On the basis of serum procalcitonin concentrations, usage of antibiotics was encouraged (PCT > or = 0.5 ng/mL) or discouraged. A relative risk of antibiotic exposure in the standard group compared with the PCT-group was 3.81 (95% CI = 2.03-7.17; p < 0.0001). The mean cost of antibiotics per patient in procalcitonin group was Euro 193.3 +/- 636.6 vs. Euro 372.1 +/- 841.1 (p = 0.206) in the standard group, while the mean cost per hospital day was Euro 8.0 +/- 18.4 vs. Euro 17.8 +/- 36.3 (p = 0.028). We found that non-infectious complications occurred in 40/102 vs. 41/103 (p = 0.592) while infections appeared in 5/102 vs. 22/103 (p = 0.001) cases. A statistically significant difference was observed in the treatme...Continue Reading

Citations

Jul 24, 2013·Evidence-based Child Health : a Cochrane Review Journal·Philipp SchuetzMatthias Briel
May 24, 2016·Annals of Pediatric Cardiology·Sujata B ChakravartiPuneet Bhatla
Feb 13, 2014·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·J SyvänenI Helenius
Jan 19, 2017·The Cochrane Database of Systematic Reviews·Brenda Ng AndrioloÁlvaro N Atallah
Oct 13, 2017·The Cochrane Database of Systematic Reviews·Philipp SchuetzBeat Mueller
Feb 9, 2017·The Cochrane Database of Systematic Reviews·Peter DaveySusan Michie

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