SynthesisCritical care (London, England)2014
Procalcitonin for diagnosis of bacterial pneumonia in critically ill patients during 2009 H1N1 influenza pandemic: a prospective cohort study, systematic review and individual patient data meta-analysis.
Synthesis in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03711227 (Procalcitonin at Zero and 24 Hours as a Prognostic Factor in Patients With Pneumonia), which is not on this map. Cited by 46 papers, 3 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.
Procalcitonin at Zero and 24 Hours as a Prognostic Factor in Patients With Pneumonia
Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- 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
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.American journal of respiratory and critical care medicine · 2019Guideline
- Procalcitonin-guided antibiotic therapy in critically ill adults: a meta-analysis.BMC infectious diseases · 2017Pooled it
- Trial
- Clinical efficacy of combined detection of serum procalcitonin and C-reactive protein in early differential diagnosis of bacterial and viral pneumonia and analysis of related inflammatory response mechanisms.Biomarkers in medicine · 2025Article
- Clinical significance of lower respiratory tract culture within 48 h of admission in patients with viral pneumonia: an observational study.BMC pulmonary medicine · 2024Observational
- Latest developments in early diagnosis and specific treatment of severe influenza infection.Journal of intensive medicine · 2024Review
- Bacterial Community- and Hospital-Acquired Pneumonia in Patients with Critical COVID-19-A Prospective Monocentric Cohort Study.Antibiotics (Basel, Switzerland) · 2024Article
- Characterization of respiratory bacterial co-infection and assessment of empirical antibiotic treatment in patients with COVID-19 at hospital admission.Scientific reports · 2023Article
- Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review.Diagnostics (Basel, Switzerland) · 2023Review
- The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza.Antibiotics (Basel, Switzerland) · 2023Article
- Antimicrobial Stewardship Techniques for Critically Ill Patients with Pneumonia.Antibiotics (Basel, Switzerland) · 2023Review
- The Role of Biomarkers in Influenza and COVID-19 Community-Acquired Pneumonia in Adults.Antibiotics (Basel, Switzerland) · 2023Review
- Assessing Biomarkers in Viral Infection.Advances in experimental medicine and biology · 2023Review
- Evaluation of Procalcitonin's Utility to Predict Concomitant Bacterial Pneumonia in Critically Ill COVID-19 Patients.Journal of intensive care medicine · 2022Article
- Low Levels of Procalcitonin Are Related to Decreased Antibiotic Use in Children Hospitalized Due to Influenza.Diagnostics (Basel, Switzerland) · 2022Article
- Plasma Levels of Mid-Regional Proadrenomedullin Accurately Identify H1N1pdm09 Influenza Virus Patients with Risk of Intensive Care Admission and Mortality in the Emergency Department.Journal of personalized medicine · 2022Article
- Epidemiologic Characteristics and Clinical Significance of Respiratory Viral Infections Among Adult Patients Admitted to the Intensive Care Unit.Frontiers in medicine · 2022Article
- [Procalcitonin in the intensive care unit : Differential diagnostic and differential therapeutic possibilities].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021Review
- [58/m-fever, cough and severe hypoxemia : Preparation for the medical specialist examination: part 65].Der Internist · 2021Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProcalcitonin (PCT) is helpful for diagnosing bacterial infections. The diagnostic utility of PCT has not been examined thoroughly in critically ill patients with suspected H1N1 influenza.
methodsClinical characteristics and PCT were prospectively assessed in 46 patients with pneumonia admitted to medical ICUs during the 2009 and 2010 influenza seasons. An individual patient data meta-analysis was performed by combining our data with data from five other studies on the diagnostic utility of PCT in ICU patients with suspected 2009 pandemic influenza A(H1N1) virus infection identified by performing a systematic literature search.
resultsPCT levels, measured within 24 hours of ICU admission, were significantly elevated in patients with bacterial pneumonia (isolated or coinfection with H1N1; n = 77) (median = 6.2 μg/L, interquartile range (IQR) = 0.9 to 20) than in patients with isolated H1N1 influenza pneumonia (n = 84; median = 0.56 μg/L, IQR = 0.18 to 3.33). The area under the curve of the receiver operating characteristic curve of PCT was 0.72 (95% confidence interval (CI) = 0.64 to 0.80; P < 0.0001) for diagnosis of bacterial pneumonia, but increased to 0.76 (95% CI = 0.68 to 0.85; P < 0.0001) when patients with hospital-acquired pneumonia and immune-compromising disorders were excluded. PCT at a cut-off of 0.5 μg/L had a sensitivity (95% CI) and a negative predictive value of 80.5% (69.9 to 88.7) and 73.2% (59.7 to 84.2) for diagnosis of bacterial pneumonia, respectively, which increased to 85.5% (73.3 to 93.5) and 82.2% (68.0 to 92.0) in patients without hospital acquired pneumonia or immune-compromising disorder.
conclusionsIn critically ill patients with pneumonia during the influenza season, PCT is a reasonably accurate marker for detection of bacterial pneumonia, particularly in patients with community-acquired disease and without immune-compromising disorders, but it might not be sufficient as a stand-alone marker for withholding antibiotic treatment.
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