Trial reportPloS one2014
A procalcitonin-based algorithm to guide antibiotic therapy in secondary peritonitis following emergency surgery: a prospective study with propensity score matching analysis.
Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- Antibiotics for Intra-Abdominal Infections: When, Which, How and How Long?Antibiotics (Basel, Switzerland) · 2025Review
- Quantifying the Relationship Between Renal Function and Procalcitonin: A Study of 14 431 Blood Cultures.Open forum infectious diseases · 2025Article
- Personalized Approaches to Patients with Intra-Abdominal Infections.Journal of clinical medicine · 2025Review
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Intra-abdominal infections survival guide: a position statement by the Global Alliance For Infections In Surgery.World journal of emergency surgery : WJES · 2024Review
- Management of Intra-Abdominal Infections: The Role of Procalcitonin.Antibiotics (Basel, Switzerland) · 2023Review
- The Impact of Antimicrobial Stewardship in Treating Patients withInnovations in pharmacy · 2023Article
- Guidelines for the Use of Procalcitonin for Rational Use of Antibiotics.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Using Procalcitonin to Guide Antibiotic Escalation in Patients With Suspected Bacterial Infection: A New Application of Procalcitonin in the Intensive Care Unit.Frontiers in cellular and infection microbiology · 2022Article
- The role of procalcitonin in reducing antibiotics across the surgical pathway.World journal of emergency surgery : WJES · 2021Review
- Predictive Analytics for Care and Management of Patients With Acute Diseases: Deep Learning-Based Method to Predict Crucial Complication Phenotypes.Journal of medical Internet research · 2021Article
- A proposal for a comprehensive approach to infections across the surgical pathway.World journal of emergency surgery : WJES · 2020Review
- Use of Procalcitonin to Guide Discontinuation of Antimicrobial Therapy in Patients with Persistent Intra-Abdominal Collections: A Case Series.Case reports in infectious diseases · 2020Article
- Prompt admission to intensive care is associated with improved survival in patients with severe sepsis and/or septic shock.The Journal of international medical research · 2018Observational
- The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery: Advantage from daily measurement.Medicine · 2018Article
- Would you like to leave Beijing, Shanghai, or Shenzhen? An empirical analysis of migration effect in China.PloS one · 2018Article
- The Predictive Role of Procalcitonin On the Treatment of Intra-Abdominal Infections.Open access Macedonian journal of medical sciences · 2017Article
- Procalcitonin-Guided Antibiotics after Surgery for Peritonitis: A Randomized Controlled Study.Gastroenterology research and practice · 2017Article
- [Antibiotic stewardship: Measures for optimization of antibacterial therapy].Der Internist · 2015Review
- Strategies for appropriate antibiotic use in intensive care unit.Einstein (Sao Paulo, Brazil)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProcalcitonin (PCT)-based algorithms have been used to guide antibiotic therapy in several clinical settings. However, evidence supporting PCT-based algorithms for secondary peritonitis after emergency surgery is scanty. In this study, we aimed to investigate whether a PCT-based algorithm could safely reduce antibiotic exposure in this population. METHODS/PRINCIPAL
findingsFrom April 2012 to March 2013, patients that had secondary peritonitis diagnosed at the emergency department and underwent emergency surgery were screened for eligibility. PCT levels were obtained pre-operatively, on post-operative days 1, 3, 5, and 7, and on subsequent days if needed. Antibiotics were discontinued if PCT was <1.0 ng/mL or decreased by 80% versus day 1, with resolution of clinical signs. Primary endpoints were time to discontinuation of intravenous antibiotics for the first episode and adverse events. Historical controls were retrieved for propensity score matching. After matching, 30 patients in the PCT group and 60 in the control were included for analysis. The median duration of antibiotic exposure in PCT group was 3.4 days (interquartile range [IQR] 2.2 days), while 6.1 days (IQR 3.2 days) in control (p < 0.001). The PCT algorithm significantly improves time to antibiotic discontinuation (p < 0.001, log-rank test). The rates of adverse events were comparable between 2 groups. Multivariate-adjusted extended Cox model demonstrated that the PCT-based algorithm was significantly associated with a 87% reduction in hazard of antibiotic exposure within 7 days (hazard ratio [HR] 0.13, 95% CI 0.07-0.21, p < 0.001), and a 68% reduction in hazard after 7 days (adjusted HR 0.32, 95% CI 0.11-0.99, p = 0.047). Advanced age, coexisting pulmonary diseases, and higher severity of illness were significantly associated with longer durations of antibiotic use. CONCLUSIONS/SIGNIFICANCE: The PCT-based algorithm safely reduces antibiotic exposure in this study. Further randomized trials are needed to confirm our findings and incorporate cost-effectiveness analysis.
trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000601831.
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