ArticleAnnals of intensive care2012
Biomarker-guided antibiotic therapy in adult critically ill patients: a critical review.
Article in Annals of intensive care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Comparison of the Diagnostic Accuracies of Procalcitonin and C-Reactive Protein for Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review.BMJ global health · 2024Pooled it
- Biomarker guided antibiotic stewardship in community acquired pneumonia: A randomized controlled trial.PloS one · 2024Trial
- A randomized trial to compare procalcitonin and C-reactive protein in assessing severity of sepsis and in guiding antibacterial therapy in Egyptian critically ill patients.Irish journal of medical science · 2021Trial
- Review
- Severe community-acquired pneumonia: an integral approach.Journal of intensive care · 2026Review
- Baseline and dynamic CALLY index changes predict mortality in sepsis-associated acute kidney injury: a two-center retrospective cohort study.Frontiers in nutrition · 2026Article
- Clinical and Therapeutic Insights into Sepsis: A Retrospective Observational Study of Inflammatory Markers, and Outcomes.Biomedicines · 2025Article
- First Signs at Admission: Prognostic Value of Initial Proinflammatory Markers for Sepsis and Mortality in ICU Patients.Pathogens (Basel, Switzerland) · 2025Article
- Interplay between C-reactive protein responses and antibiotic prescribing in people with suspected infection.BMC infectious diseases · 2025Article
- Serial biomarker measurements may be helpful to predict the successful application of high flow nasal cannula in COVID-19 pneumonia patients.Scientific reports · 2025Article
- Article
- Harnessing the host response for precision infectious disease diagnosis.Clinical microbiology reviews · 2024Review
- Sepsis Biomarkers: Advancements and Clinical Applications-A Narrative Review.International journal of molecular sciences · 2024Review
- Biomarkers in pulmonary infections: a clinical approach.Annals of intensive care · 2024Review
- Distinct patterns of vital sign and inflammatory marker responses in adults with suspected bloodstream infection.The Journal of infection · 2024Article
- Progress in Procalcitonin Detection Based on Immunoassay.Research (Washington, D.C.) · 2024Review
- Clinical usefulness of presepsin and monocyte distribution width (MDW) kinetic for predicting mortality in critically ill patients in intensive care unit.Frontiers in medicine · 2024Article
- How to use biomarkers of infection or sepsis at the bedside: guide to clinicians.Intensive care medicine · 2023Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Biomarkers of infection, namely C-reactive protein and procalcitonin (PCT), are potentially useful in the diagnosis of infection as well as in the assessment of its response to antibiotic therapy. C-reactive protein variations overtime appears to have a good performance for the diagnosis of infection. Procalcitonin shows a better correlation with clinical severity. In addition, to overcome the worldwide problem of antibiotic overuse as well as misuse, biomarker guidance of antibiotic stewardship represents a promising new approach. In several randomized, controlled trials, including adult critically ill patients, PCT guidance was repeatedly associated with a decrease in the duration of antibiotic therapy. However, these trials present several limitations, namely high rate of patients' exclusion, high rate of algorithm overruling, long duration of antibiotic therapy in the control group, disregard the effect of renal failure on PCT level, and above all a possible higher mortality and higher late organ failure in the PCT arm. In addition, some infections (e.g., endocarditis) as well as frequent nosocomial bacteria (e.g., Pseudomonas aeruginosa) are not suitable to be assessed by PCT algorithms. Therefore, the true value of PCT-guided algorithm of antibiotic stewardship in assisting the clinical decision-making process at the bedside remains uncertain. Future studies should take into account the issues identified in the present review.
Identifiers
What OpenQuestion holds
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.