Do we need new trials of procalcitonin-guided antibiotic therapy?

Detalhes bibliográficos
Autor(a) principal: Lisboa, Thiago
Data de Publicação: 2018
Outros Autores: Salluh, Jorge, Povoa, Pedro
Tipo de documento: Outros
Idioma: eng
Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Texto Completo: http://hdl.handle.net/10362/146732
Resumo: Funding Information: Publication was funded by Rede Institucional de Pesquisa e Inovação em Medicina Intensiva (RIPIMI), Complexo Hospitalar Santa Casa de Misericordia de Porto Alegre. Publisher Copyright: © 2018 The Author(s).
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spelling Do we need new trials of procalcitonin-guided antibiotic therapy?Critical Care and Intensive Care MedicineFunding Information: Publication was funded by Rede Institucional de Pesquisa e Inovação em Medicina Intensiva (RIPIMI), Complexo Hospitalar Santa Casa de Misericordia de Porto Alegre. Publisher Copyright: © 2018 The Author(s).Using biomarkers as a guide to tailor the duration of antibiotic treatment in respiratory infections is an attractive hypothesis assessed in several studies. Recent work aiming to summarize the evidence assessed the effect of a procalcitonin (PCT)-guided antibiotic treatment on outcomes in acute lower respiratory tract infections (LRTI), suggesting that significant reductions in antibiotic duration occur when using a PCT-guided algorithm. However, controversial evidence also suggested PCT-guided algorithms were associated with increased antibiotic duration and increased incidence of Clostridium difficile, without any impact on mortality, in real-world settings. So, although using PCT-guided antibiotic stewardship is promising, after more than a decade of randomized controlled trials on this topic the evidence in its favor is still less than compelling due to limitations in trial design, not taking into consideration fundamental aspects of PCT biology, and the absence of evidence-based antimicrobial duration in intervention and control groups. In this commentary we highlight some questions and limitations of primary PCT study data that might impact interpretation and clinical use of PCT at the bedside.Centro de Estudos de Doenças Crónicas (CEDOC)NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNLisboa, ThiagoSalluh, JorgePovoa, Pedro2022-12-28T22:15:28Z2018-01-272018-01-27T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/otherapplication/pdfhttp://hdl.handle.net/10362/146732eng1364-8535PURE: 49097099https://doi.org/10.1186/s13054-018-1948-6info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T18:07:37Zoai:run.unl.pt:10362/146732Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:38:14.641550Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Do we need new trials of procalcitonin-guided antibiotic therapy?
title Do we need new trials of procalcitonin-guided antibiotic therapy?
spellingShingle Do we need new trials of procalcitonin-guided antibiotic therapy?
Lisboa, Thiago
Critical Care and Intensive Care Medicine
title_short Do we need new trials of procalcitonin-guided antibiotic therapy?
title_full Do we need new trials of procalcitonin-guided antibiotic therapy?
title_fullStr Do we need new trials of procalcitonin-guided antibiotic therapy?
title_full_unstemmed Do we need new trials of procalcitonin-guided antibiotic therapy?
title_sort Do we need new trials of procalcitonin-guided antibiotic therapy?
author Lisboa, Thiago
author_facet Lisboa, Thiago
Salluh, Jorge
Povoa, Pedro
author_role author
author2 Salluh, Jorge
Povoa, Pedro
author2_role author
author
dc.contributor.none.fl_str_mv Centro de Estudos de Doenças Crónicas (CEDOC)
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Lisboa, Thiago
Salluh, Jorge
Povoa, Pedro
dc.subject.por.fl_str_mv Critical Care and Intensive Care Medicine
topic Critical Care and Intensive Care Medicine
description Funding Information: Publication was funded by Rede Institucional de Pesquisa e Inovação em Medicina Intensiva (RIPIMI), Complexo Hospitalar Santa Casa de Misericordia de Porto Alegre. Publisher Copyright: © 2018 The Author(s).
publishDate 2018
dc.date.none.fl_str_mv 2018-01-27
2018-01-27T00:00:00Z
2022-12-28T22:15:28Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/other
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/146732
url http://hdl.handle.net/10362/146732
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1364-8535
PURE: 49097099
https://doi.org/10.1186/s13054-018-1948-6
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eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
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repository.mail.fl_str_mv info@rcaap.pt
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