Table 2.
Principal characteristics of the randomized controlled trials assessing the role of PCT-guided antibiotic stewardship in adult critically ill patients
| Trial | Sample size | Rate of exclusion (%) | Infections Community/nosocomial | Pneumonia | PCT assay | Minimum duration AB therapy | Decision to start antibiotics (no AB), PCT/control | Duration of antibiotic therapy, PCT/control, days | Overruling PCT algorithm (%) | LOS ICU, PCT/control, days | Superinfection, PCT/control, N(%) | Relapse, PCT/control, N(%) | Mortality 28d, PCT/control, N(%) | Mortality 60d, PCT/control, N(%) | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Svoboda, 2007 [43] |
|
72 |
381 (84) |
0/72 |
NA |
PCT-Q |
|
|
|
|
16.1 ± 6.9/19.4 ± 8.9 |
|
|
10/38 (26 %)/13/34 (38 %) |
|
| Nobre, 2008 [41] |
ProSEP |
79 |
203 (72) |
53/26 |
52 |
TRACE |
|
|
8 (4–27)/14 (6–39) |
19 |
4 (1–21)/7 (1–91) |
7/31 (22.5 %)/11/37 (29.7 %) |
1/39 (2.6 %)/1/40 (2.5 %) |
8/39 (20.5 %)/8/40 (20 %) |
|
| Schroeder, 2009 [44] |
|
27 |
98 (78) |
0/27 |
8 |
PCT LIA |
yes |
|
6.6 ± 1.1/8.3 ± 0.7 |
|
16.4 ± 8.3/16.7 ± 5.6 |
|
|
3/14 (21.4 %)/3/13 (23.1 %) |
|
| Stolz, 2009 [45] |
ProVAP |
101 |
63 (38) |
0/101 |
101 |
TRACE |
yes |
|
10 (6–16)/15 (10–23) |
16 |
13 (7–21)/13.5 (8–22.2) |
7/51 (13.7 %)/6/50 (12 %) |
|
8/51 (16 %)/12/50 (24 %) |
|
| Hochreiter, 2009 [46] |
ProSICU |
110 |
285 (72) |
0/110 |
43 |
PCT LIA |
|
|
5.9 ± 1.7/7.9 ± 0.5 |
|
15.5 ± 12.5/17.7 ± 10.1 |
|
|
15/57 (26.3 %)/14/53 (26.4 %) |
|
| Bouadma, 2010 [42] |
PRORATA |
601 |
685 (52) |
326/275 |
394 |
TRACE |
yes |
4 (1.7 %)/15 (4.8 %) |
10.3 ± 7.7/13.3 ± 7.6 |
53 |
15.9 ± 16.1/14.4 ± 14.1 |
106/307 (34.5 %)/97/314 (30.9 %) |
20/307 (6.5 %)/16/314 (5.1 %) |
65/307 (21.2 %)/64/314 (20.4 %) |
92/307 (30 %)/82/314 (26.1 %) |
| Jensen, 2011 [47] | PASS | 1200 | 3 (0.3) | 480/720 | 666 | TRACE | 6 (3–11)/4 (3–10) | 17.9 | 6 (3–12)/5 (3–11) | 190/604 (31.5 %)/191/596 (32 %) | 231/604 (38.2 %)/220/596 (36.9 %) |
Results are expressed as mean ± standard deviation or median (interquartile range) unless otherwise indicated.
AB = antibiotics; LOS = length of stay; PCT = procalcitonin; PCT LIA = luminescence immunoassay; PCT-Q = semiquantitative immunochromatographic method; TRACE = time-resolved amplified cryptate emission.