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Procalcitonin-Guided Antibiotic Therapy Proved Effective in CAP Cure

erefore, the results from bacterial cultures are not considered central to the clinical care of the patient.

At the start of the study, all participants were deemed similar with respect to the pneumonia severity index and clinical, laboratory-related and microbiological characteristics.

By basing antibiotic treatment on individual procalcitonin levels, the investigators reduced the average duration of antibiotic use by 55 percent (to 5 days), in contrast to the 12 days of use associated with the ‘usual care’ patients.

Researchers assessed data on each subject at baseline, at 4, 6 and 8 days, and after six weeks.

It took less than 20 minutes to detect levels of serum procalcitonin in the laboratory and results were routinely available within an hour. Each test cost between $15 and $30.

‘Procalcitonin appears to be a more reliable measure for individual tailoring and early discontinuance of antibiotic therapy as compared with the routinely used clinical and other parameters,’ said Dr. Müller.

In an editorial on the research in the same issue of the journal, Richard G. Wunderink, M.D., of the Feinberg School of Medicine at Northwestern University in Chicago, noted that procalcitonin does not return to low levels for two weeks in bacteremic patients and is also delayed in severe CAP. ‘The pattern of procalcitonin therapy response in such patients appears to be more a marker of ongoing inflammation than persistent infection,’ Dr. Wunderink wrote.

Although the therapy may reduce the duration of antibiotic treatment by an average of seven days, he noted that 14-day treatment of CAP is no longer standard. ‘Clinical trials and newer guidelines for management of CAP suggest that shorter courses, 7 days or less, should be used. Therefore, the use of a procalcitonin-guided therapy is unlikely to make a major impact if current guidelines are followed.’

He concluded: ‘The major implication of this stu
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