Increase in Procalcitonin Kinetics May be a Good Indicator of Starting Empirical Antibiotic Treatment in Critically Ill Patients

Domonkos Trásy114 enrolled

Overview

The value of procalcitonin change from the day before to the day when infection was suspected in predicting bacterial infection in intensive care patients.

Starting antibiotic therapy early in critically ill patients with suspected infection is of utmost importance with significant effect on survival. Procalcitonin is a reliable sepsis marker but results about its usefulness in initiating antimicrobials are conflicting. Our aim is to investigate the predictive value of 24 hours procalcitonin kinetics before starting empirical antibiotic therapy in intensive care patients as an indicator of the presence of bacterial infection.

Study Type

OBSERVATIONAL

Enrollment

114

Conditions

Bacterial Infection

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Clinical signs of infection * Suspected or proven acute infection requiring empiric antibiotic therapy as decided by the attending ICU physician * Microbiological sample sent for staining * Inflammatory markers available from the previous day Exclusion Criteria: * Patients younger than 18 years * Who received prophylactic or empiric antibiotic therapy 48 hours before inclusion * Whose receiving acute renal replacement therapy in the first 24 hours following antibiotic treatment * Following cardiopulmonary resuscitation * End stage diseases with a "do not resuscitate" order * Immunocompromised patients (human immunodeficiency virus infection, bone marrow transplantation, malignant haematological disorders and chemotherapy) * Post cardiac surgery patients

Locations (1)

Department of Anaesthesiology and Intensive Therapy

Szeged, Csongrád megye, Hungary

Outcomes

Primary Outcomes

Procalcitonin kinetic

Procalcitonin levels are measured at starting empiric antibiotic treatment and 24 hours before. The changes in percentage are calculated form the day before and right before the first exposition of the antibiotic therapy.

Time frame: 24 hours before starting empiric antibiotic treatment

Secondary Outcomes

C-reactive protein kinetic

C-reactive protein levels are measured at starting empiric antibiotic treatment and 24 hours before. The changes in percentage are calculated form the day before and right before the first exposition of the antibiotic therapy.

Time frame: 24 hours before starting empiric antibiotic treatment

Body temperature kinetic

Body temperatures are measured at starting empiric antibiotic treatment and 24 hours before. The changes in percentage are calculated form the day before and right before the first exposition of the antibiotic therapy.

Time frame: 24 hours before starting empiric antibiotic treatment

White blood cell count kinetic

White blood cell count levels are measured at starting empiric antibiotic treatment and 24 hours before. The changes in percentage are calculated form the day before and right before the first exposition of the antibiotic therapy.

Time frame: 24 hours before starting empiric antibiotic treatment

Data from ClinicalTrials.gov

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