Critical Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Diagn Microbiol Infect Dis. 2013 Jul;76(3):266-71. doi: 10.1016/j.diagmicrobio.2013.03.027. Epub 2013 May 25.
Biomarkers such as procalcitonin (PCT) have been studied to guide duration of antibiotic therapy. We aimed to assess whether a decrease in PCT levels could be used to reduce the duration of antibiotic therapy in intensive care unit (ICU) patients with a proven infection without risking a worse outcome. We assessed 265 patients with suspected sepsis, severe sepsis, or septic shock in our ICU. Of those, we randomized 81 patients with a proven bacterial infection into 2 groups: an intervention group in which the duration of the antibiotic therapy was guided by a PCT protocol and a control group in which there was no PCT guidance. In the per-protocol analysis, the median antibiotic duration was 9 days in the PCT group (n = 20) versus 13 days in the non-PCT group (n = 31), P = 0.008. This study demonstrates that PCT can be a useful tool for limiting antimicrobial therapy in ICU patients with documented bacterial infection.
生物标志物，如降钙素原 (PCT)，已被研究用于指导抗生素治疗的持续时间。我们旨在评估 PCT 水平的降低是否可用于减少 ICU 中已证实感染的患者的抗生素治疗时间，而不会增加不良结局的风险。我们评估了在 ICU 中患有疑似败血症、严重败血症或败血症性休克的 265 名患者。其中，我们将 81 名具有明确细菌感染的患者随机分为 2 组：干预组的抗生素治疗时间由 PCT 方案指导，对照组则没有 PCT 指导。在符合方案分析中，PCT 组（n = 20）的中位抗生素治疗时间为 9 天，而非 PCT 组（n = 31）为 13 天，P = 0.008。这项研究表明，PCT 可作为 ICU 中确诊细菌感染患者限制抗菌治疗的有用工具。
