Related Experiment Video
Updated: Jul 8, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Procalcitonin Guided Antibiotic Stewardship in Pediatric Sepsis and Lower Respiratory Tract Infections
Adyasha Kanungo1, Swathi Rao2, Sumanth Shetty Bellipady1
1Department of Pediatrics, NITTE (Deemed to be University), KS Hegde Medical Academy, Karnataka, India.
Insights
Procalcitonin-guided antibiotic stewardship protocols (PCT-ASP) significantly reduced antibiotic duration and hospital stays in pediatric sepsis and lower respiratory tract infections. This approach improved outcomes without increasing patient morbidity or mortality.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Biomarker-Guided Therapy
Background:
- Sepsis and lower respiratory tract infections are common in children, often leading to prolonged antibiotic use.
- Optimizing antibiotic therapy is crucial to combat antimicrobial resistance and improve patient outcomes.
- Procalcitonin (PCT) has emerged as a valuable biomarker for guiding antibiotic decisions.
Purpose of the Study:
- To evaluate the effectiveness of a procalcitonin-guided antibiotic stewardship protocol (PCT-ASP) in pediatric patients.
- To assess the impact of PCT-ASP on antibiotic duration and clinical outcomes in children with sepsis and lower respiratory tract infections.
Main Methods:
- A single-center study comparing children treated with PCT-ASP (study group) to those treated with standard protocols (control group).
- Primary outcomes included median duration of antibiotic therapy and hospital stay.
- Procalcitonin levels were monitored at admission, day 4, and day 6.
Main Results:
- The study included 66 patients in the PCT-ASP group and 61 in the control group.
- PCT levels showed a decreasing trend during antibiotic therapy in the study group.
- The PCT-ASP group experienced significantly shorter durations of antibiotic therapy (p=0.001) and hospital stay (p=0.03) compared to the control group.
- 12% of children in the study group did not receive antibiotics initially, and 53% received antibiotics for only three days.
Conclusions:
- PCT-ASP effectively reduces antibiotic exposure in pediatric sepsis and lower respiratory tract infections.
- The protocol leads to shorter hospital stays without compromising patient safety or increasing adverse events.
- Procalcitonin monitoring is a valuable tool for optimizing antibiotic stewardship in pediatric critical care.
Objectives:
To determine the impact of procalcitonin-guided antibiotic stewardship protocol (PCT-ASP) in children admitted with sepsis and lower respiratory tract infection on the duration of antibiotic therapy and clinical outcome.
Methods:
This was a single-center study involving children with infections treated with antibiotic therapy according to the PCT-ASP as the study group. The control group consisted of children with same age and diagnosis who were treated with antibiotics according to individual unit protocol before the implementation of PCT-ASP. The primary outcome was median duration of antibiotic therapy and hospital stay.
Results:
Among 127 patients, 66 were enrolled in the study and 61 in the control group respectively. The median (IQR) PCT values at admission, day 4 and day 6 of antibiotic therapy were 5.59 (61.3), 2.57 (47.35), and 0.35 (0.47) ng/ml respectively, and showed a decreasing trend. All the children in the control group received antibiotics at admission while 12% of children in the study group were not initiated on antibiotics. In the study group, 53% of the children received antibiotics only for three days in the absence of treatment failure. The duration of antibiotics (p = 0.001) and hospital stay (p = 0.03) were less in the study group when compared to the control group.
Conclusions:
PCT-ASP reduces the duration of antibiotics and duration of hospital stay without increasing morbidity and mortality.
More Related Videos
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:26Tonsillitis II: Management
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...