ABSTRACT

Background

Our objective was to assess the impact on mortality, antibacterial therapy duration, and length of stay of using PCT to guide antibiotic cessation in critically ill patients with sepsis or septic shock.

Research design and Methods

A systematic literature search was performed in PubMed, Embase, ISI Web of Knowledge, BioMed Central, ScienceDirect and the Cochrane Central Register of Controlled Trials, of clinical trials published in English before December 31, 2019. Eligible studies should be carried out in adults at ICU with sepsis, comparing the PCT-guided antimicrobial therapy with standard of care. A random effects model was used.

Results

Twelve studies were eligible with a total of 4292 patients included. The combined relative risk for 28-day mortality was 0.89 (95% CI: 0.79; 0.99), for the duration of antimicrobial therapy was −1.98 days (95% CI: −2.76, −1.21) and for ICU- length of stay was-1.21 days (95% CI: −4.16, 1.74).

Conclusions

In critically ill adults with sepsis, a procalcitonin-guided strategy is associated with a significant shorter duration of antimicrobial therapy. This reduction was associated with a significant decrease in mortality although the length of ICU stay was not affected.

中文翻译：

---

基于降钙素原算法对危重成人脓毒症患者抗生素治疗持续时间的临床影响：随机临床试验的荟萃分析

摘要

背景

我们的目的是评估使用 PCT 指导脓毒症或感染性休克重症患者停用抗生素对死亡率、抗菌治疗持续时间和住院时间的影响。

研究设计和方法

在 PubMed、Embase、ISI Web of Knowledge、BioMed Central、ScienceDirect 和 Cochrane Central Register of Controlled Trials 中对 2019 年 12 月 31 日之前以英语发表的临床试验进行了系统的文献检索。符合条件的研究应在成人中进行ICU 脓毒症，比较 PCT 指导的抗菌治疗与护理标准。使用了随机效应模型。

结果

12 项研究符合条件，共纳入 4292 名患者。28 天死亡率的综合相对风险为 0.89（95% CI：0.79；0.99），抗菌治疗持续时间为 -1.98 天（95% CI：-2.76，-1.21），ICU 住院时间为-1.21 天（95% CI：-4.16，1.74）。

结论

在患有脓毒症的危重成人中，以降钙素原为指导的策略与显着缩短抗菌治疗的持续时间相关。这种减少与死亡率的显着降低有关，尽管 ICU 住院时间没有受到影响。