Patients in the ICU whose infection is resolving will be randomized to standard duration of antibiotics compared to duration determined by a combination of a procalcitonin value and a simple evaluation of clinical status.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
1
In the experimental arm, antibiotics will be stopped based upon the PCT-guided algorithm. This PCT algorithm also incorporates clinical parameters to ensure utmost safety for the patients. These clinical parameters are; resolution of fever (temperature less than 38.3 and greater than 36.0), shock (on no vasopressors), and leukocytosis (\<12,000 and \>4,000).
Royal Columbian Hospital
New Westminster, British Columbia, Canada
Antibiotic- free days and alive at 14 days after ICU admission
Time frame: 14 days
mortality at 28 days
Time frame: 28 days
mortality at 90 days
Time frame: 90 days
ventilator days at 28 days
Time frame: 28 days
ICU free days at 28 days
Time frame: 28 days
relapsed infection
Time frame: 30 days
rates of CDAD
Time frame: 30 days
colonization/infection with VRE/MRSA over next 30 days
Time frame: 30 days
duration of abx in control arm for those with and without formal stewardship programs
Time frame: 14 days
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