Trial reportCritical care (London, England)2009
Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial.
Trial report in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 135 papers, 23 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Natural History of Procalcitonin in Hemorrhagic Stroke
Reduction of the Duration of Antibiotic Guided by Procalcitonin in Infections Lungs of Hospitalized Elderly: a Randomized
Procalcitonin as a Sepsis Biomarker in Guiding Antibiotics Treatment Duration in Ventilator Associated Pneumonia in Neuro-ICU: A Randomised Controlled Trial
Who cites it
135 citing papers in PubMed, 23 syntheses or guidelines pooled it, 313 citations in OpenAlex.
- Pooled it
- Non-Infectious Causes for Elevated Procalcitonin.Medicina (Kaunas, Lithuania) · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Society of Critical Care Medicine and the Infectious Diseases Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU.Critical care medicine · 2023Pooled it
- Procalcitonin-guided antibiotic therapy may shorten length of treatment and may improve survival-a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials.Age and ageing · 2021Pooled it
- The prognostic value of serum procalcitonin measurements in critically injured patients: a systematic review.Critical care (London, England) · 2019Pooled it
- Pooled it
- Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in intensive care unit patients with infection and sepsis patients: a patient-level meta-analysis of randomized trials.Critical care (London, England) · 2018Pooled it
- A meta-analysis to assess usefulness of procalcitonin-guided antibiotic usage for decision making.The Indian journal of medical research · 2017Pooled it
- Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.The Cochrane database of systematic reviews · 2017Pooled it
- Procalcitonin-guided antibiotic therapy in critically ill adults: a meta-analysis.BMC infectious diseases · 2017Pooled it
- Interventions to improve antibiotic prescribing practices for hospital inpatients.The Cochrane database of systematic reviews · 2017Pooled it
- Effectiveness and safety of procalcitonin evaluation for reducing mortality in adults with sepsis, severe sepsis or septic shock.The Cochrane database of systematic reviews · 2017Pooled it
- Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Guideline
- Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults.The Cochrane database of systematic reviews · 2015Pooled it
- Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock--a systematic review and meta-analysis.Critical care (London, England) · 2013Pooled it
- De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock.The Cochrane database of systematic reviews · 2013Pooled it
- Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.The Cochrane database of systematic reviews · 2012Pooled it
- Procalcitonin to guide initiation and duration of antibiotic treatment in acute respiratory infections: an individual patient data meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012Pooled it
75 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe development of resistance by bacterial species is a compelling issue to reconsider indications and administration of antibiotic treatment. Adequate indications and duration of therapy are particularly important for the use of highly potent substances in the intensive care setting. Until recently, no laboratory marker has been available to differentiate bacterial infection from viral or non-infectious inflammatory reaction; however, over the past years, procalcitonin (PCT) is the first among a large array of inflammatory variables that offers this possibility. The present study aimed to investigate the clinical usefulness of PCT for guiding antibiotic therapy in surgical intensive care patients.
methodsAll patients requiring antibiotic therapy based on confirmed or highly suspected bacterial infections and at least two concomitant systemic inflammatory response syndrome criteria were eligible. Patients were randomly assigned to either a PCT-guided (study group) or a standard (control group) antibiotic regimen. Antibiotic therapy in the PCT-guided group was discontinued, if clinical signs and symptoms of infection improved and PCT decreased to <1 ng/ml or the PCT value was >1 ng/ml, but had dropped to 25 to 35% of the initial value over three days. In the control group antibiotic treatment was applied as standard regimen over eight days.
resultsA total of 110 surgical intensive care patients receiving antibiotic therapy after confirmed or high-grade suspected infections were enrolled in this study. In 57 patients antibiotic therapy was guided by daily PCT and clinical assessment and adjusted accordingly. The control group comprised 53 patients with a standardized duration of antibiotic therapy over eight days. Demographic and clinical data were comparable in both groups. However, in the PCT group the duration of antibiotic therapy was significantly shorter than compared to controls (5.9 +/- 1.7 versus 7.9 +/- 0.5 days, P < 0.001) without negative effects on clinical outcome.
conclusionsMonitoring of PCT is a helpful tool for guiding antibiotic treatment in surgical intensive care patients. This may contribute to an optimized antibiotic regimen with beneficial effects on microbial resistance and costs in intensive care medicine. ANNOTATION: Results were previously published in German in Anaesthesist 2008; 57: 571-577 (PMID: 18463831).
trial registrationISRCTN10288268.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.