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
| Autor: | Mohd A.H. Ismail, Saedah Ali, Mahamarowi Omar, Mohd Zulfakar Mazlan, Wan Fadzlina Wan Muhd Shukeri, Zeti Norfidiyati Salmuna |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Point-of-Care Systems Critical Care and Intensive Care Medicine Procalcitonin law.invention Sepsis Randomized controlled trial c-reactive protein law Anesthesiology Internal medicine medicine Humans RD78.3-87.3 clinical pulmonary infection score biology business.industry RC86-88.9 C-reactive protein Ventilator-associated pneumonia Pneumonia Ventilator-Associated ventilator-associated pneumonia Medical emergencies. Critical care. Intensive care. First aid General Medicine bacterial infections and mycoses medicine.disease Intensive care unit Confidence interval Anti-Bacterial Agents Intensive Care Units Pneumonia Anesthesiology and Pain Medicine point-of-care biology.protein business Biomarkers procalcitonin |
| Zdroj: | Anaesthesiology Intensive Therapy, Vol 53, Iss 3, Pp 207-214 (2021) |
| ISSN: | 1731-2531 1642-5758 |
| Popis: | Introduction 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). Material and 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 β [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. |
| Databáze: | OpenAIRE |
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