Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions.
Identifieur interne : 005187 ( Ncbi/Merge ); précédent : 005186; suivant : 005188Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions.
Auteurs : Yannick Wirz [Suisse] ; Angela Branche [États-Unis] ; Michel Wolff [France] ; Tobias Welte [Allemagne] ; Vandack Nobre [Brésil] ; Konrad Reinhart [Allemagne] ; Ann R. Falsey [États-Unis] ; Pierre Damas [Belgique] ; Albertus Beishuizen [Pays-Bas] ; Rodrigo O. Deliberato [Brésil] ; Yahya Shehabi [Australie] ; Jens-Ulrik S. Jensen [Danemark] ; Beat Mueller [Suisse] ; Philipp Schuetz [Suisse]Source :
- ACS infectious diseases [ 2373-8227 ] ; 2017.
Abstract
Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.
DOI: 10.1021/acsinfecdis.7b00199
PubMed: 29120606
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<front><div type="abstract" xml:lang="en">Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.</div>
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<Abstract><AbstractText>Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.</AbstractText>
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<AffiliationInfo><Affiliation>Faculty of Medicine, University of Basel , Petersplatz, 4031 Basel, Switzerland.</Affiliation>
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<ForeName>Tobias</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary Medicine, Medizinische Hochschule Hannover , Carl-Neuberg-Straße 1, 30625 Hannover, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nobre</LastName>
<ForeName>Vandack</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Department of Intensive Care, Hospital das Clinicas da Universidade Federal de Minas Gerais , 110 Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brasil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Reinhart</LastName>
<ForeName>Konrad</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital , Am Klinikum 1, 07747 Jena, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Falsey</LastName>
<ForeName>Ann R</ForeName>
<Initials>AR</Initials>
<AffiliationInfo><Affiliation>National Institute of Allergy and Infectious Diseases Respiratory Pathogen Research Center, University of Rochester Medical Center , 601 Elmwood Ave., Rochester, New York 14642, United States.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Damas</LastName>
<ForeName>Pierre</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of General Intensive Care, University Hospital of Liege, domaine universitaire du Sart Tilman, , 4000 Liège, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Beishuizen</LastName>
<ForeName>Albertus</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Intensive Care Center, Medisch Spectrum Twente, Koningsplein 1, 7512KZ, Enschede, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Deliberato</LastName>
<ForeName>Rodrigo O</ForeName>
<Initials>RO</Initials>
<AffiliationInfo><Affiliation>Critical Care Unit, Hospital Israelita Albert Einstein , Av. Albert Einstein, 627/701, Morumbi, São Paulo, São Paulo 05652-900, Brazil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shehabi</LastName>
<ForeName>Yahya</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Critical Care and Peri-operative Medicine, Monash Health , Clayton Rd., Clayton, Victoria 3171, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>School of Clinical Sciences, Monash University , E Block, Level 5, Monash Medical Centre, Clayton, Victoria 3168, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jensen</LastName>
<ForeName>Jens-Ulrik S</ForeName>
<Initials>JS</Initials>
<AffiliationInfo><Affiliation>CHIP & PERSIMUNE, Department of Infectious Diseases, Finsencentret, Rigshospitalet, University of Copenhagen , Blegdamsvej 9, 2100 København, Denmark.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Internal Medicine, Respiratory Medicine, Herlev & Gentofte Hospital , Niels Andersens Vej 28, 2900 Hellerup, Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mueller</LastName>
<ForeName>Beat</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Medical University Department, Kantonsspital Aarau , Tellstrasse, 5000 Aarau, Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculty of Medicine, University of Basel , Petersplatz, 4031 Basel, Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schuetz</LastName>
<ForeName>Philipp</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Medical University Department, Kantonsspital Aarau , Tellstrasse, 5000 Aarau, Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculty of Medicine, University of Basel , Petersplatz, 4031 Basel, Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2017</Year>
<Month>11</Month>
<Day>09</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>ACS Infect Dis</MedlineTA>
<NlmUniqueID>101654580</NlmUniqueID>
<ISSNLinking>2373-8227</ISSNLinking>
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<Month>11</Month>
<Day>10</Day>
<Hour>6</Hour>
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<Month>11</Month>
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<Month>11</Month>
<Day>10</Day>
<Hour>6</Hour>
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<ArticleId IdType="doi">10.1021/acsinfecdis.7b00199</ArticleId>
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<li>Australie</li>
<li>Belgique</li>
<li>Brésil</li>
<li>Danemark</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region><li>Basse-Saxe</li>
<li>Hovedstaden</li>
<li>Province de Liège</li>
<li>État de São Paulo</li>
<li>Île-de-France</li>
</region>
<settlement><li>Copenhague</li>
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<li>Liège</li>
<li>Paris</li>
<li>São Paulo</li>
</settlement>
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</noRegion>
<name sortKey="Mueller, Beat" sort="Mueller, Beat" uniqKey="Mueller B" first="Beat" last="Mueller">Beat Mueller</name>
<name sortKey="Schuetz, Philipp" sort="Schuetz, Philipp" uniqKey="Schuetz P" first="Philipp" last="Schuetz">Philipp Schuetz</name>
</country>
<country name="États-Unis"><noRegion><name sortKey="Branche, Angela" sort="Branche, Angela" uniqKey="Branche A" first="Angela" last="Branche">Angela Branche</name>
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<name sortKey="Falsey, Ann R" sort="Falsey, Ann R" uniqKey="Falsey A" first="Ann R" last="Falsey">Ann R. Falsey</name>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Wolff, Michel" sort="Wolff, Michel" uniqKey="Wolff M" first="Michel" last="Wolff">Michel Wolff</name>
</region>
</country>
<country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Welte, Tobias" sort="Welte, Tobias" uniqKey="Welte T" first="Tobias" last="Welte">Tobias Welte</name>
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<name sortKey="Reinhart, Konrad" sort="Reinhart, Konrad" uniqKey="Reinhart K" first="Konrad" last="Reinhart">Konrad Reinhart</name>
</country>
<country name="Brésil"><noRegion><name sortKey="Nobre, Vandack" sort="Nobre, Vandack" uniqKey="Nobre V" first="Vandack" last="Nobre">Vandack Nobre</name>
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<name sortKey="Deliberato, Rodrigo O" sort="Deliberato, Rodrigo O" uniqKey="Deliberato R" first="Rodrigo O" last="Deliberato">Rodrigo O. Deliberato</name>
</country>
<country name="Belgique"><region name="Province de Liège"><name sortKey="Damas, Pierre" sort="Damas, Pierre" uniqKey="Damas P" first="Pierre" last="Damas">Pierre Damas</name>
</region>
</country>
<country name="Pays-Bas"><noRegion><name sortKey="Beishuizen, Albertus" sort="Beishuizen, Albertus" uniqKey="Beishuizen A" first="Albertus" last="Beishuizen">Albertus Beishuizen</name>
</noRegion>
</country>
<country name="Australie"><noRegion><name sortKey="Shehabi, Yahya" sort="Shehabi, Yahya" uniqKey="Shehabi Y" first="Yahya" last="Shehabi">Yahya Shehabi</name>
</noRegion>
</country>
<country name="Danemark"><region name="Hovedstaden"><name sortKey="Jensen, Jens Ulrik S" sort="Jensen, Jens Ulrik S" uniqKey="Jensen J" first="Jens-Ulrik S" last="Jensen">Jens-Ulrik S. Jensen</name>
</region>
</country>
</tree>
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