Background: Procalcitonin is a biomarker used to determine the length of antibiotic therapy in sepsis patients. The severity of systemic infection and the existence of organ failure are linked to the degree of Procalcitonin induction. As a result, PCT is considered a helpful biomarker for the diagnosis of sepsis, and new research suggests that dynamic variations in PCT may be predictive of specific outcomes in patients with severe sepsis and septic shock.
Materials and Methods: A prospective, randomised, controlled, interventional trial was done in a mixed adult intensive care unit (ICU). In a nonblinded trial, 90 adult patients with sepsis and septic shock were randomly assigned to one of two groups: group P (procalcitonin) or group C (calcitonin) (group control). In comparison to usual treatment procedures in group C, the duration of antibiotic therapy for patients in group P was determined based on serum procalcitonin levels. The criteria for stopping antibiotic medication was set at a procalcitonin value of 0.01 ng/mL or a subsequent decline of more than 80% from the baseline. The major purpose was to compare the two groups' antibiotic treatment durations (in days). The secondary purpose was to compare and analyse the length of ICU stay, reinfection, secondary infection rate, readmission rate, and mortality rate of the different groups.
The average duration of antibiotic therapy in patients in the group of. P (4.98 2.56 vs 7.73 3.06 days, p 0.001) was significantly shorter. Patients in group C stayed in the ICU for longer (8.80 3.35 days vs 5.98 2.73 days, p 0.001). Group C had a considerably greater rate of secondary infection (26.7 percent vs. 4.4 percent, p = 0.014). Readmission and death rates were similar among groups.
Conclusion: A serum procalcitonin-based approach could reduce antibiotic medication, ICU stay, and associated morbidities such secondary infection rates in critically ill sepsis patients. It also encourages antibiotic stewardship without negatively impacting the patient's result. As a result, generalising the findings to a group that includes all of the cases indicated above is impossible. To confirm the findings of our investigation, more multicenter studies with larger populations are needed.
Author (S) Details
S. M. Gowri Vishalakshi
Department of Anaesthesia and Intensive Care, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.
Poonam Gupta
Department of Anaesthesia and Intensive Care, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.
Pardeep Kumar Verma
Department of Anaesthesia and Intensive Care, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.
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