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Table 2 PCT assays and algorithms used for procalcitonin (PCT)-guided treatment in the included studies

From: Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock – a systematic review and meta-analysis

Study PCT test Regimen in the PCT group Regimen in the control group
Annane et al. 2013[26] Brahms PCT Kryptor Medical patients: Antibiotic treatment at the discretion of the patient’s physician
PCT <0.25 ng/mL: antibiotics not initiated or stopped
PCT ≥ 0.25 and < 0.5 ng/mL: Antibiotics strongly discouraged
PCT ≥0.5 and <5 ng/mL: antibiotics recommended
PCT ≥5 ng/mL: antibiotics strongly recommended
Surgical patients:
PCT <4 ng/mL: antibiotics not initiated or stopped
PCT ≥4 and <9 ng/mL: antibiotics recommended
PCT ≥9 ng/mL: antibiotics strongly recommended
Bouadma et al. 2010[27] Brahms PCT Kryptor Guidelines for starting of antibiotics: Treatment according to international and local guidelines
PCT <0.25 ng/mL: antibiotics strongly discouraged
PCT ≥0.25 and <0.5 ng/mL: antibiotics discouraged
PCT ≥0.5 and <1 ng/mL: antibiotics encouraged
PCT ≥1 ng/mL: antibiotics strongly encouraged
Guidelines for continuing or stopping of antibiotics:
PCT <0.25 ng/mL: stopping of antibiotics strongly encouraged.
Decrease by ≥80% from peak concentration, or concentration ≥0.25 and <0.5 ng/mL: stopping of antibiotics encouraged
Decrease by <80% from peak concentration and concentration ≥0.5 ng/mL: continuing of antibiotics encouraged
Increase of concentration compared with peak concentration and concentration ≥0.5 ng/mL: changing of antibiotics strongly encouraged
Hochreiter et al. 2009[28] Brahms PCT LIA PCT < 1 ng/mL: Antibiotics discontinued. Antibiotic treatment according to standard regimen over 8 days
PCT >1 ng/mL and dropped to 25 to 35% of the initial value over 3 days: antibiotics discontinued
Additionally the infection had to improve clinically
Jensen et al. 2011[29] Brahms PCT Kryptor Single baseline measurement of PCT ≥1.00 ng/mL or PCT ≥1.00 ng/mL and not decreased at least 10% from the previous day: Antibiotic treatment according to current guidelines
1) increasing the antimicrobial spectrum covered
2) intensifying the diagnostic effort to find uncontrolled sources of infection
PCT <1.00 ng/mL for at least 3 days: de-escalation possible
Nobre et al. 2008[30] Brahms PCT Kryptor Patients with PCT <1 ng/mL re-evaluated at day 3: antibiotics discontinued if PCT <0.1 ng/mL Antibiotic treatment based on empirical rules
Patients with PCT ≥1 ng/mL re-evaluated at day 5: antibiotics discontinued if PCT dropped >90% from the baseline peak level or if PCT <0,25 ng/mL
Schroeder et al. 2009[31] Brahms PCT LIA PCT <1 ng/mL and clinical signs of infection improved: antibiotics discontinued Antibiotic treatment according to clinical signs and empiric rules
PCT dropped to <35% of the initial concentration within 3 days and clinical signs of infection improved: antibiotics discontinued
Svoboda et al. 2007[32] Brahms PCT-Q PCT >2 ng/mL: change of antibiotics and catheters Treatment according to contemporary treatment protocol of the institute
PCT ≤2 ng/mL: ultrasonography and/or computer tomography followed by repeated surgical treatment if localized infection was confirmed
  1. PCT, procalcitonin.