Meta-analysis of procalcitonin-guided antibiotics therapy in patients with severe bacterial infection

LI Gang; XIANG Fang; and CHEN Zhuo

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Medical Journal of the Chinese People Armed Police Forces ›› 2016, Vol. 27 ›› Issue (3) : 250-252.

ORIGINAL ARTICLES

Meta-analysis of procalcitonin-guided antibiotics therapy in patients with severe bacterial infection

LI Gang¹, XIANG Fang¹, and CHEN Zhuo²

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Abstract

Objective To investigate the effectiveness and safety of procalcitonin-guided therapy in patients with servere infection. Methods Pubmed, Embase and the Cochrane Central Register of Controlled Trials were searched(up to June, 2015).Studies on randomized controlled trials clollected data on all-cause mortality and the duration of antibiotic therapy were included and analysised by Revman 5. Results 8 studies involving 783 patients with PCT guidance treatment and 744 patients with traditional treatment were included.Compared with the control group, with META analysis, researches showed that the duration of antibiotic use was reduced in procalcitonin-guided group (Z=1.08, P=0.28) while the mortality rate of patients was not significantly different between the two groups(Z=0.37, P=0.71). Conclusions Procalcitonin-guided antibiotics therapy in patients with severe bacterial infection can be effective and safe in a shorter duration of antibiotic treatment.

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procalcitonin / severe infection / antibiotics / Meta-analysis

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LI Gang, XIANG Fang, and CHEN Zhuo. Meta-analysis of procalcitonin-guided antibiotics therapy in patients with severe bacterial infection[J]. Medical Journal of the Chinese People Armed Police Forces. 2016, 27(3): 250-252

References

[1]Dombrovskiy V Y, Martin A A, Sunderram J,et al. Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003 [J]. Crit Care Med, 2007, 35(5):1244-1250.
[2] Iskander K N, Osuchowski M F, Stearns-Kurosawa D J,et al. Sepsis:multiple abnormalities, heterogeneous responses, and evolving understanding[J].Physiol Rev,2013,93:1247-1288.
[3] Jadad A R, Moore R A, Carroll,et al. Assessing the quality of reports of randomized clinical trials is blinding necessary[J].Control Clin Trials,1996,17:1-12.
[4] Svoboda P, Kantorova I, Scheer P,et al. Can procalcitonin help us in timing of re-intervention in septic patients after multiple trauma or major surgery[J].Hepatogastroenterology, 2007, 54:359-363.
[5] Nobre V,Harbarth S,Graf J,et al. Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial[J].Am J Respir Crit Care Med,2008,177: 498-505.
[6] Hochreiter M, Koehler T, Schweiger A M,et al. Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial[J].Crit Care,2009, 13:R83.
[7] Schroeder S,Hochreiter M,Koehler T,et al. Procalcitonin(PCT)-guided algorithm reduces length of antibiotic treatment in surgical intensive care patients with severe sepsis: results of a prospective randomized study [J].Langenbecks Arch Surg,2009,394: 221-226.
[8] Stolz D, Smyrnios N, Eggimann P,et al. Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomised study[J].Eur Respir J,2009,34:1364-1375.
[9] Bouadma L, Luyt C E, Tubach F,et al. Use of procalcitonin to reduce patients’ exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial[J].Lancet,2010,375:463-474.
[10] Jensen J U, Hein L, Lundgren B,et al.Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial[J].Crit Care Med,2011,39:2048-2058.
[11] Annane D, Maxime V, Faller J P,et al. Procalcitonin levels to guide antibiotic therapy in adults with non-microbiologically proven apparent severe sepsis: a randomised controlled trial[J].BMJ Open,2013,3:e002186.