Increase in Procalcitonin Kinetics May be a Good Indicator of Starting Empirical Antibiotic Treatment in Critically Ill Patients

Domonkos Trásy

Status: Completed

Conditions: Bacterial Infection

Study type: Observational

Funder types: Other

Identifiers

NCT02311816

PCT-infection

Details and patient eligibility

About

The value of procalcitonin change from the day before to the day when infection was suspected in predicting bacterial infection in intensive care patients.

Full description

Starting antibiotic therapy early in critically ill patients with suspected infection is of utmost importance with significant effect on survival. Procalcitonin is a reliable sepsis marker but results about its usefulness in initiating antimicrobials are conflicting. Our aim is to investigate the predictive value of 24 hours procalcitonin kinetics before starting empirical antibiotic therapy in intensive care patients as an indicator of the presence of bacterial infection.

Enrollment: 114 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Clinical signs of infection
• Suspected or proven acute infection requiring empiric antibiotic therapy as decided by the attending ICU physician
• Microbiological sample sent for staining
• Inflammatory markers available from the previous day

Exclusion criteria

• Patients younger than 18 years
• Who received prophylactic or empiric antibiotic therapy 48 hours before inclusion
• Whose receiving acute renal replacement therapy in the first 24 hours following antibiotic treatment
• Following cardiopulmonary resuscitation
• End stage diseases with a "do not resuscitate" order
• Immunocompromised patients (human immunodeficiency virus infection, bone marrow transplantation, malignant haematological disorders and chemotherapy)
• Post cardiac surgery patients

Trial design

114 participants in 2 patient groups

Infection

Description:

Based on the microbiological results and clinical picture patients were grouped post hoc into "infection" and "no infection" groups by two independent experts (intensivist, infectologist) who were blinded for procalcitonin.

No infection

Description:

Based on the microbiological results and clinical picture patients were grouped post hoc into "infection" and "no infection" groups by two independent experts (intensivist, infectologist) who were blinded for procalcitonin.