Hochreiter 2009

Methods	Randomised clinical trial, single‐centre, intensive care unit in Germany
Participants	Inclusion criteria: patients in the surgical ICU with suspected bacterial infections and > 1 SIRS criteria Exclusion criteria: patients who refused study consent, whose antibiotic treatment had been initiated before intensive care admission, or who had therapy limitations Included in this analysis: 43 (110): 67 not considered for this analysis due to diagnosis other than ARI
Interventions	Guiding antibiotic decisions in postoperative patients in a surgical ICU Algorithm used in this study: AB therapy in the procalcitonin‐guided group was discontinued if clinical signs and symptoms of infection improved and procalcitonin decreased to less than 1 µg/L, or if the procalcitonin value was more than 1 µg/L, but had dropped to 25 to 35% of the initial value over 3 days
Outcomes	Antibiotic use Mortality (ICU‐free days alive)
Notes	Funding: BRAHMS AG Follow‐up: until hospital discharge Registration: ISRCTN10288268
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Unconcealed drawing of lots
Allocation concealment (selection bias)	High risk	Unconcealed drawing of lots
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Open‐label trial where physicians knew in which group patients were and where procalcitonin levels were only communicated in the intervention arm
Blinding of outcome assessment (detection bias) All outcomes	High risk	Non‐blinded study members
Incomplete outcome data (attrition bias) All outcomes	Low risk	Follow‐up for mortality: 393/394 (100%)
Selective reporting (reporting bias)	Low risk	No selective reporting (oral verification with first author)
Other bias	Unclear risk	Adherence to procalcitonin protocol not reported/assessed