Procalcitonin-Guided Antibiotic Therapy. Clinician Research Summary.

摘要

In response to a request from a national professional society regarding the use of procalcitonin in the clinical management of adult and pediatric patients with suspected local or systemic infection, a systematic review of comparative studies (randomized controlled trials and nonrandomized studies) was conducted. The patient populations included critically ill adults with suspected sepsis or other serious bacterial infections, neonates with suspected early neonatal sepsis, patients with upper and lower respiratory tract infections, children with fever of unknown origin, and postoperative patients at risk of infection. Pregnant women, patients with absolute neutropenia and other immunocompromised populations (solid organ and stem-cell transplant recipients, patients with advanced HIV infection/AIDS), and patients with chronic infections such as infective endocarditis were excluded from this review. The systematic review included 18 reports of eligible studies in over 6,000 patients published between January 1, 1990, and December 16, 2011. Outcomes including antibiotic usage, mortality, morbidity, adverse drug effects of antibiotic therapy, and hospital or intensive care unit (ICU) length of stay were assessed. This summary, based on the full report of research evidence, is provided to assist in decisionmaking along with consideration of a patients values and preferences. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines.