Procalcitonin-guided strategy lowers antibiotic exposure in Acute Chest Syndrome in SCD
Acute chest syndrome (ACS) is a major complication of SCD, and a significant cause for morbidity and mortality in adult patients. ACS is characterized by fever and/or respiratory symptoms with new pulmonary infiltrates.
Since establishing a definitive etiology is not always possible, empirical antibiotic therapy is often used in ACS. Procalcitonin is currently the most useful biomarker used to distinguish sepsis from other causes of inflammation and determine the bacterial origin of a pneumonia. Its concentrations are raised during bacterial invasion rather than viral infection ; its elevation magnitude correlates with infection severity, and decreasing levels over time correlate with infection resolution.
In a recent study researchers have proved that a procalcitonin-guided strategy to prescribe antibiotics in patients with ACS may reduce antibiotic exposure with no apparent adverse outcomes.
Researchers performed a prospective before–after study in medical wards and an intensive-care unit (ICU). During the control phase, clinicians were blinded to procalcitonin concentration results. They built an algorithm using the obtained measurements to hasten antibiotic cessation after three days of treatment if bacterial infection was not documented, and procalcitonin concentrations were all <0.5 μg/L.
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