Schroeder 2009

Methods	Randomised clinical trial, single‐centre, surgical ICU in Germany
Participants	Inclusion criteria: patients after abdominal surgery with antibiotic treatment because of severe sepsis in the surgical ICU Exclusion criteria: patients were excluded if they did not meet the respective inclusion criteria, refused informed consent or already had received antibiotic treatment prior to admission to the ICU Included in this analysis: 8 out of 27 randomised patients: 19 not considered for this analysis due to diagnosis other than RTI
Interventions	Guiding antibiotic decisions in postoperative patients in a surgical ICU Algorithm used in this study: in the procalcitonin‐guided group, antibiotic therapy was discontinued if clinical signs and symptoms of sepsis improved and procalcitonin values either had decreased to 1 µg/L or less or had dropped to 25% to 35% of the initial procalcitonin concentration over 3 consecutive days
Outcomes	Antibiotic use Mortality (ICU‐free days alive)
Notes	Funding: NA Follow‐up: until hospital discharge Registration: none
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: 8/8 (100% until discharge)
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