Table 1.
Characteristics of included trials
| First author (year) | Country | Setting, type of trial | Patients included | Follow-up | Clinical diagnosis | Type of procalcitonin algorithm; procalcitonin cutoffs used (μg/L)a | Compliance with the PCT protocol |
|---|---|---|---|---|---|---|---|
| Annane (2013) [7] | France | ICU, multicenter | 62 | Hospital stay | Severe sepsis without overt source of infection and negative blood culture | Initiation and duration; R against AB: < 0.5 (< 0.25); R for AB: > 0.5 (> 5.0) | 63% adherence |
| Bloos (2016) [8] | Germany | ICU, multicenter | 1089 | 3 months | Severe sepsis or septic shock (SIRS and documented infection + criteria for severe sepsis/septic shock) | Discontinuation at days 4, 7, and 10; R against AB: < 1.0 or > 50% drop over previous value | 49.6% adherence |
| Bouadma (2010) [9] | France | ICU, multicenter | 621 | 2 months | Critically ill patients with assumed/proven bacterial infection | Initiation and duration; R against AB: < 0.5 (< 0.25); R for AB: > 0.5 (> 1.0) | 47% adherence |
| De Jong (2016) [10] | The Netherlands | ICU, multicenter | 1546 | 1 year | Critically ill patients with assumed infection | Duration; R against AB: < 0.5 or > 80% drop over peak value | 44% adherence |
| Deliberato (2013) [11] | Brazil | ICU, single center | 81 | ICU discharge or 14 days postrandomization | Sepsis patients with microbiologically confirmed bacterial infection | Duration; R against AB: < 0.5 or > 90% drop over peak value | 47.6% adherence |
| Hochreiter (2009) [14] | Germany | Surgical ICU, single center | 110 | Hospital stay | Sepsis (SIRS and documented infection) | Duration; R against AB: < 1 or > 65% drop over 3 days | not reported |
| Layios (2012) [15] | Belgium | ICU, single center | 379 | 1 month | Critically ill patients with assumed infection | Initiation; R against AB: < 0.5 (< 0.25); R for AB: > 0.5 (> 1.0) | 46.3% adherence |
| Nobre (2008) [17] | Switzerland | ICU, single center | 79 | 1 month | Severe sepsis or septic shock | Duration; R against AB: < 0.5 (< 0.25) or > 80% drop over peak value; R for AB: > 0.5 (> 1.0) | 81% adherence |
| Oliveira (2013) [16] | Brazil | ICU, multicenter | 94 | 28 days or hospital discharge | Severe sepsis or septic shock (SOFA score > 10 and/or bacteremia) | Discontinuation; Initial < 1.0: R against AB: 0.1 at day 4; Initial > 1.0: R against: > 90% drop over peak value | 87.8% adherence |
| Schroeder (2009) [13] | Germany | Surgical ICU, single center | 27 | Hospital stay | Severe sepsis following abdominal surgery (SIRS and documented infection + criteria for severe sepsis/septic shock) | Duration; R against AB: < 1 or > 65% drop over 3 days | not reported |
| Shehabi (2014) [1] | Australia | ICU, multicenter | 394 | 3 months | Sepsis (SIRS and documented infection) | Duration; R against AB: < 0.25 (< 0.1) or > 90% drop over peak value | 97% adherence |
AB antibiotic, ICU intensive care unit, PCT procalcitonin, R recommendation, SIRS systemic inflammation response system, SOFA Sequential Organ Failure Assessment
a Cutoffs are listed as recommendation (strong recommendation)