Adherence to a procalcitonin-guided antibiotic treatment protocol in patients with severe sepsis and septic shock

• DOI: 10.1186/s13613-018-0415-5
• Publication Date: 2018-06-04T10:40:31Z
• Authors: Andreas Hohn; Nina Balfer; Bernhard Heising; Sabine Hertel; Jan C. Wiemer; Marcel Hochreiter; Stefan Schröder
• Keywords: Procalcitonin

In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates overruling, thus the value PCT-guided real clinical life outside study conditions remains unclear. this study, a PCT guide patients with severe sepsis septic shock analysed.From 2012 2014, surgical ICU or were retrospectively screened for measurement series appropriate make decisions therapy. We compared (1) without series; (2) who reached stopping advice threshold (PCT < 0.5 ng/mL and/or decrease 10% peak level) did not reach threshold; (3) treated adherently non-adherently The groups terms duration, kinetics, other outcomes.Of 81 shock, 14 excluded due restriction short course ICU. final analysis performed 67 Forty-two (62.7%) had series. series, median initial (p = 0.001) levels higher those non-appropriate 26 an advice. 8 advice, antibiotics discontinued (30.8%). Patients shorter (7d [IQR 6-9] vs. 12d 9-16]; p 0.002). No differences seen outcomes.In testing irregular local life. duration negative outcomes. Procalcitonin values kinetics clear impact regularity testing.