Using Procalcitonin Tests to reduce antibiotics duration in Neurosurgical patients with Ventilated Associated Pneumonia
Patients who are more than 18 years old who are admitted to Neurosurgical ICU will be recruited 48hours after ventilation if matches criteria for ventilator associated pneumonia. Patients will be randomised into 2 groups. first group will be procalcitonin guided in addition to conventionally guided sepsis assessment (TWC, CRP, body temperature). second group is only conventionally guided sepsis assessment. in procalcitonin guided group, blood sample will be taken on Day 1 of recruitment and day 5. On day 5 , the procalcitonin level will be compared to recommendations in PRORATA trial. If procalcitonin level is below the level to withhold antibiotics, recommendation will be made to the primary physician to off the antibiotics. Another Procalcitonin level will be repeated on Day 7 to rule out reinfection. This study aims to compare the duration of antibiotics and length of ICU stay among the 2 groups. This study will fill up the gap among the lack of datas in neurosurgical patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
48
procalcitonin test will be taken on day 1 of recruitment as baseline, test done on day 5 will decide whether antibiotics will be withheld, followed by day 7 to determine rate of reinfection.
To compare the duration of antibiotics between PCT versus Standard of care guided stopping antibiotic
compare the duration of antibiotics between 2 arms
Time frame: 14 days
To compare the length of ICU stay in between PCT versus Standard of care guided stopping antibiotic
compare the length of ICU stay in between 2 arms
Time frame: 14 days
To compare 14 days mortality rate in between 2 arms
compare 14 days mortality rate in between 2 arms
Time frame: 14 days
To compare proportion of difficult to treat organisms (MRO) in between 2 arms
compare proportion of difficult to treat organisms (MRO) in between 2 arms
Time frame: 14 days
To compare the proportion of reinfection within 72 hours after stopping antibiotics
compare the proportion of reinfection within 72 hours after stopping antibiotics
Time frame: 14 days
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