Early changes of procalcitonin may advise about prognosis and appropriateness of antimicrobial therapy in sepsis

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• 作者：Antonia-Panagiota Georgopoulou MD^a ; Athina Savva MD^b ; Evangelos J. Giamarellos-Bourboulis MD ; PhD^b ; ^{giamarel@ath.forthnet.gr"" rel=""nofollow} ; Marianna Georgitsi^b ; Maria Raftogiannis MD ; PhD^b ; Nicolaos Antonakos MD^b ; Efterpi Apostolidou MD^c ; Dionyssia-Pinelopi Carrer MD^b ; George Dimopoulos MD ; PhD^d ; Aggelos Economou MD^b ; George Efthymiou MD^e ; Nearchos Galanakis MD ; PhD^f ; Labrini Galani MD^b ; Panagiotis Gargalianos MD ; PhD^g ; Ilias Karaiskos MD^b ; Chrisostomos Katsenos MD^h ; Dimitra Kavatha MD ; PhD^b ; Evangelos Koratzanis MD^b ; Panagiotis Labropoulos MD^e ; Malvina Lada MD^a ; George Nakos MD ; PhDⁱ ; Evgenia Paggalou MD^j ; George Panoutsopoulos MD ; PhD^k ; Michael Paraschos MD^h ; Ioannis Pavleas MD ; PhD^j ; Konstantinos Pontikis MD^d ; Garyfallia Poulakou MD ; PhD^b ; Athanassios Prekates MD ; PhD^l ; Styliani Sybardi MD^d ; Maria Theodorakopoulou MD^d ; Christina Trakatelli MD ; PhD^m ; Panagiotis Tsiaoussis MDⁿ ; Charalambos Gogos MD ; PhD^o ; Helen Giamarellou MD ; PhD^b ; Apostolos Armaganidis MD ; PhD^d ; Michael Meisner MD ; PhD^p ; on behalf of the Hellenic Sepsis Study Group
• 关键词：Procalcitonin ; Sepsis ; Prognosis ; Guidance of antimicrobials
• 刊名：Journal of Critical Care
• 出版年：2011
• 出版时间：June 2011
• 年：2011
• 卷：26
• 期：3
• 页码：331.e1-331.e7
• 全文大小：278 K

文摘

<h4 class=""h4"">Purposeh3>The objective of this study is to define if early changes of procalcitonin (PCT) may inform about prognosis and appropriateness of administered therapy in sepsis.<h4 class=""h4"">Methodsh3>

A prospective multicenter observational study was conducted in 289 patients. Blood samples were drawn on day 1, that is, within less than 24 hours from advent of signs of sepsis, and on days 3, 7, and 10. Procalcitonin was estimated in serum by the ultrasensitive Kryptor assay (BRAHMS GmbH, Hennigsdorf, Germany). Patients were divided into the following 2 groups according to the type of change of PCT: group 1, where PCT on day 3 was decreased by more than 30 % or was below 0.25 ng/mL, and group 2, where PCT on day 3 was either increased above 0.25 ng/mL or decreased less than 30 % .<h4 class=""h4"">Resultsh3>

Death occurred in 12.3 % of patients of group 1 and in 29.9 % of those of group 2 (P < .0001). Odds ratio for death of patients of group 1 was 0.328. Odds ratio for the administration of inappropriate antimicrobials of patients of group 2 was 2.519 (P = .003).<h4 class=""h4"">Conclusionsh3>

Changes of serum PCT within the first 48 hours reflect the benefit or not of the administered antimicrobial therapy. Serial PCT measurements should be used in clinical practice to guide administration of appropriate antimicrobials.