Navigation Links
Customized treatments for sepsis lower treatment time and reduce length of ICU stays
Date:2/28/2008

Using a blood test and a decision algorithm, rather than standard hospital protocols, to determine the appropriate length of antibiotic therapy in patients with severe sepsis or septic shock can reduce duration of treatments, shorten ICU stays, and lower hospital costs all without adverse effects on patients, according to new research.

We have shown that it is possible to customize antibiotic treatment duration in patients with septicemia based on a reliable and robust blood test, says Jrme Pugin, M.D., of the Intensive Care Unit at the University Hospital in Geneva, Switzerland.

The findings appear in the first issue for March of the American Journal of Respiratory and Clinical Care Medicine, published by the American Thoracic Society.

The researchers randomized 79 patients to receive a treatment course of antibiotics either according standard treatment protocols administered by the treating physicians, or according to the decision algorithm based on measured blood levels of procalcitonin (PCT), a marker for severe bacterial infection in patients with suspected sepsis. For patients randomized to the PCT-based treatment there were predetermined stopping rules based on circulating PCT levels at which point investigators encouraged treating physicians to discontinue antibiotic therapy, although the treating physician retained the ultimate decision-making power.

In the analysis that included all 79 patients, the median treatment time for the PCT group was 3.5 fewer days than that of the control group, although the difference was not significant. However, once the investigators controlled for early drop-outs, previously undiagnosed infections, and patients whose physicians declined to stop antibiotic treatment when the algorithm would have dictated it, they found that patients treated by the PCT algorithm had a significantly shorter treatment time at 6 days, than patients treated according to standard protocols, who averaged 12.5 days on antibiotics.

Our study is the first randomized clinical trial in which a surrogate biochemical parameter was used to reduce the duration of antibiotic therapy in a population of critically ill patients admitted to the ICU for severe sepsis and septic shock, wrote Dr. Pugin. Despite the relatively short duration of treatment in bacteremic patients assigned to the PCT group, no case of recurrence of infection was observed in these patients.

Following the PCT algorithm had another benefit: patients randomized to the PCT treatment had significantly shorter stays in the ICU than control patientsan average of three days versus five.

Customizing treatment does more than simply save hospitals money and patients precious days in the ICU, says Dr. Pugin. Overuse of antibiotics can result in antibiotic resistance. Given the diversity of the types of infections, bacterial strains and levels of host immune defense, every infected patient should benefit from a personalized treatment, and particularly, a personalized treatment duration, he said.

The investigators hope that customized treatments will continue to improve care for sepsis patients around the world. We have now implemented this new algorithm based on procalcitonin guidance in our ICU for patients presenting with severe sepsis and septic shock, and are following the outcome of those patients, said Dr. Pugin. Currently, three large multi-center trials are ongoing in France, Denmark and Germany, with a design similar to that of our study. Results from these studies will be important to determine whether such a protocol of procalcitonin guidance is definitely safe and can be generalized worldwide.


'/>"/>

Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. Unique Gift for Valentines Day: Canine Cancer Campaign Customized Dog Tag - for Your Dog or as a Beautiful Piece of Jewelry for a Special Human
2. Sutter Solano Cancer Center Offers Oncology Patients Customized Cancer Treatment
3. LodgeNet Deploys Customized Kid Friendly Solution With Childrens Hospital of Pittsburgh of UPMC
4. Customized virus kills brain tumor stem cells that drive lethal cancer
5. Comparison of antipsychotic treatments in adolescents with schizophrenia
6. Biomarkers for Mood May Alter Psychiatric Treatments
7. Alimera Sciences Signs Second Agreement With Emory University for Potential Treatments Using New Class of Antioxidants
8. Study finds spine surgery yields greater benefits over nonsurgical treatments
9. New Stroke Treatments Reduce Brain Damage, Improve Recovery
10. Varian Medical Systems Announces Symposia on RapidArc Technology for Faster, More Precise Radiotherapy Treatments
11. No Difference Found in Treatments for Acute Kidney Failure
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... The International Association ... standards of excellence for the field of eating disorders, announces the opening of ... 2018 in Orlando, Florida at the Omni Resort at ChampionsGate. , ...
(Date:10/13/2017)... ... October 13, 2017 , ... Apple Rehab Shelton Lakes , which ... evacuation of the facility as part of a disaster drill on October 3rd. , ... and Shelton City Emergency Manager, as well as the Connecticut Long Term Care ...
(Date:10/13/2017)... ... October 13, 2017 , ... Global Healthcare Management’s 4th Annual Kids ... Milford, NJ. This free event, sponsored by Global Healthcare Management’s CEO, Jon Letko, ... run is geared towards children of all ages; it is a non-competitive, non-timed event, ...
(Date:10/13/2017)... ... 2017 , ... “The Journey: From the Mountains to the Mission Field”: the ... in the Philippines. “The Journey: From the Mountains to the Mission Field” is the ... She has taught all ages and currently teaches a class of ladies at her ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of the largest and fastest ... to open a flagship location in Covington, LA at 401 N. U.S. Highway 190, ... next to Office Depot in the Holiday Square shopping center. Its location allows it ...
Breaking Medicine News(10 mins):
(Date:10/7/2017)... --  Provista, a proven leader in the supply ... power, today announced a new resource area on Provistaco.com ... is the online home for case studies, articles on ... releases, slideshows and events. ... at their fingertips, viewers can also watch short videos ...
(Date:10/4/2017)... to the Centers for Disease Control and Prevention (CDC), influenza vaccination ... is helping communities across Massachusetts , Connecticut ... flu shots through the end of the month. *Some exclusions ... ... shot is by the end of October, according to the Centers for ...
(Date:10/2/2017)... , Oct. 2, 2017  Eli Lilly and ... financial results for the third quarter of 2017 on ... conference call on that day with the investment community ... The conference call will begin at 9 ... can access a live webcast of the conference call ...
Breaking Medicine Technology: