PURPOSE: Procalcitonin is a useful and prognostic biomarker for antibiotic therapy in lower respiratory tract infection.This study aims to assess the initiation and the duration of antibiotic therapy and the clinical outcome with the guidance of procalcitonin level.
METHODS: In a randomized, single blined study, 122 patients, 24~82 of age, with community acquired pneumonia were included. The control group(n=62) received antibiotics according to the usual practice guideline. In the procalcitonin group(n=60), antibiotics were discontinued on the basis of cutoff level(< 0.25ug/L). Data were analyzed at baseline,day 4,7,10 and 6wk with antibiotic use and clinical, radiographic and laboratory outcome.
RESULTS: At baseline, both groups were similar regarding clinical characteristics. In the procalcitonin group, antibiotic prescriptions on admission(91.7 vs 98.4%, p< 0.05)and the duration of antibiotic therapy(9.2 vs 14.6d, p< 0.001))were reduced compared with the control group. There was no difference in clinical, radiographic and laboratory outcome as well as in overall success rate(83 vs 85%) and mortality(13.8 vs 14.3%) between two groups.
CONCLUSION: Procalcitonin guidance reduced the duration of antibiotic use in patients with community acquired pneumonia, and similar outcome were shown compared with patients treated according to the usual practice guideline.
CLINICAL IMPLICATIONS: During the treatment of lower respiratory tract infection,we should use procalcitonin levels as a very useful biomarker to reduce the duration and unnecessary prescriptions of antibiotics. Also we consider that cost and antibiotic resistance will be reduced.
DISCLOSURE: Yong-Ho Roh, No Financial Disclosure Information; No Product/Research Disclosure Information