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Effect of semi-quantitative procalcitonin assay on the adequacy of empirical antibiotics and mortality in septic patients
© Dharaniyadewi et al.; licensee BioMed Central Ltd. 2013
- Published: 5 November 2013
- Septic Patient
- Great Probability
- Hospital Emergency
- Considerable Morbidity
Sepsis is a serious clinical condition with a considerable morbidity and mortality. Procalcitonin (PCT) is a good biomarker for early diagnosis and infection monitoring. A semi-quantitative PCT assay can be performed at the bedside and has good diagnostic value [1, 2]. The present study aimed to investigate the effect of a semi-quantitative PCT test on the empirical antibiotic initiation time, the appropriateness of empirical antibiotics and mortality in septic patients.
The study design was a randomized diagnostic trial, which was also a pragmatic trial. Septic patients more than 18 years old with and without signs of organ hypoperfusion or dysfunction who were admitted to Cipto Mangunkusomo Hospital emergency department in the internal medicine unit were eligible. Subjects were randomly assigned to either a semi-quantitative PCT-examined group (study group) or a control group. Semi-quantitative PCT test results will be informed to the physicians taking care of the patients. The primary outcome was 14-day mortality. Secondary outcomes were the time of initiation and appropriateness of empirical antibiotics. A Tropical Infection Consultant will assess the appropriateness of empirical antibiotics based on Pedoman Umum Penggunaan Antibiotik Departemen Kesehatan Republik Indonesia.
Baseline characteristics of the patients
Semi-quantitative PCT-examined group, n (%)
Control group, n(%)
Mean age (years)
51.4 ± 15.7
48.6 ± 46.0
Severe sepsis and septic shock
Source of infection
Effect of semi-quantitative procalcitonin assay on adequacy of empirical antibiotics and mortality in septic patients
Semi-quantitative PCT assay, n(%)
RR (95% CI)
Empirical antibiotic initiation time
2.48 (1.88 to 3.26)
Appropriateness of empirical antibiotics
0.99 (0.92 to 1.08)
0.53 (0.36 to 0.77)
Semi-quantitative PCT examination affects the empirical antibiotic initiation time and mortality in septic patients, but not the appropriateness of empirical antibiotics.
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