Guidance of antibiotic therapy with procalcitonin in lower respiratory tract infections: Insights into the ProHOSP study
Guidance of antibiotic therapy with procalcitonin in lower respiratory tract infections: Insights into the ProHOSP study
复制标题
降钙素原抗生素治疗下呼吸道感染的指导：ProHOSP 研究的见解
作者：
P. Schuetz;M. Christ;W. Albrich;W. Zimmerli;B. Mueller
在最近发表的ProHOSP试验中，我们调查了降钙素原(PCT)指导下呼吸道感染(主要是肺炎)不同严重程度患者抗生素治疗的安全性和外部有效性。在这份附录中，我们旨在通过加强PCT算法的合理性和提供关于不同感染严重程度的抗生素治疗的更详细的数据来扩展最初的报告。在病情较轻的患者中，大多数是病毒性呼吸道感染(即急性或慢性支气管炎)，由于大多数患者的PCT仍然很低，PCT指导下的抗生素初始处方显著减少。在肺炎中，PCT呈严重程度依赖性升高，血培养阳性患者的PCT水平最高。因此，肺炎的主要作用是严重程度和菌血症适应的抗生素疗程的缩短。在下呼吸道感染中，PCT指导对抗生素暴露有不同的影响，这取决于呼吸道感染的潜在类型和严重程度。
In the recently published ProHOSP trial, we investigated the safety and external validity of procalcitonin (PCT) guidance for antibiotic therapy in patients with different severities of lower respiratory tract infections, mainly pneumonia. In this addendum, we aim to extend the initial report by reinforcing the rational of the PCT algorithm and by presenting more detailed data on antibiotic therapy in different severities of infection. In milder, mostly viral respiratory infections (i.e. acute or chronic bronchitis) initial prescription of antibiotics was markedly reduced by PCT guidance because PCT remained low in most patients. In pneumonia, PCT showed a severity-dependent increase and highest levels in patients with positive blood cultures. Thus, the main effect in pneumonia was a severity- and bacteremia-adapted reduction of the duration of antibiotic courses. In lower respiratory tract infections, PCT guidance had a differential effect on antibiotic exposure depending on the underlying type and severity of respiratory tract infection.
影响因子：
158.5
作者：
Fine, MJ;Auble, TE;Kapoor, WN
通讯作者：
Kapoor, WN