Trial reportCritical care (London, England)2014
Procalcitonin guidance for reduction of antibiotic use in patients hospitalized with severe acute exacerbations of asthma: a randomized controlled study with 12-month follow-up.
Trial report in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 6 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Procalcitonin-guided antibiotic treatment in patients with cancer: a patient-level meta-analysis from randomized controlled trials.BMC cancer · 2024Pooled it
- Interventions to improve appropriate antibiotic prescribing in long-term care facilities: a systematic review.BMC geriatrics · 2020Pooled it
- Antibiotics for exacerbations of asthma.The Cochrane database of systematic reviews · 2018Pooled it
- Antibiotic stewardship interventions in hospitals in low-and middle-income countries: a systematic review.Bulletin of the World Health Organization · 2018Pooled it
- Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.The Cochrane database of systematic reviews · 2017Pooled it
- Interventions to improve antibiotic prescribing practices for hospital inpatients.The Cochrane database of systematic reviews · 2017Pooled it
- Guidelines for the Initial Assessment of Respiratory Distress in the Emergency Department.Annals of intensive care · 2026Article
- Extended antibiotic exposure and exacerbations, mortality, and healthcare costs in asthma.Scientific reports · 2025Article
- Promising treatment biomarkers in asthma.Frontiers in drug safety and regulation · 2023Review
- Antimicrobial Stewardship Using Biomarkers: Accumulating Evidence for the Critically Ill.Antibiotics (Basel, Switzerland) · 2022Review
- Role of Polypeptide Inflammatory Biomarkers in the Diagnosis and Monitoring of COVID-19.International journal of peptide research and therapeutics · 2022Review
- Treatment Response Biomarkers in Asthma and COPD.Diagnostics (Basel, Switzerland) · 2021Review
- A behavioural approach to specifying interventions: what insights can be gained for the reporting and implementation of interventions to reduce antibiotic use in hospitals?The Journal of antimicrobial chemotherapy · 2020Article
- Association of Antibiotic Treatment With Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated With Systemic Corticosteroids.JAMA internal medicine · 2019Article
- Article
- Outpatient Antibiotic Stewardship: A Growing Frontier-Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic Use.Open forum infectious diseases · 2018Article
- Procalcitonin-guided diagnosis and antibiotic stewardship revisited.BMC medicine · 2017Review
- [Infection and asthma].Open respiratory archivesReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatients with severe acute exacerbations of asthma often receive inappropriate antibiotic treatment. We aimed to determine whether serum procalcitonin (PCT) levels can effectively and safely reduce antibiotic exposure in patients experiencing exacerbations of asthma.
methodsIn this randomized controlled trial, a total of 216 patients requiring hospitalization for severe acute exacerbations of asthma were screened for eligibility to participate and 169 completed the 12-month follow-up visit. Patients were randomized to either PCT-guided (PCT group) or standard (control group) antimicrobial therapy. In the control group, patients received antibiotics according to the attending physician's discretion; in the PCT group, patients received antibiotics according to an algorithm based on serum PCT levels. The primary end point was antibiotic exposure; secondary end points were clinical recovery, length of hospital stay, clinical and laboratory parameters, spirometry, number of asthma exacerbations, emergency room visits, hospitalizations and need for corticosteroid use due to asthma.
resultsPCT guidance reduced antibiotic prescription (48.9% versus 87.8%, respectively; P < 0.001) and antibiotic exposure (relative risk, 0.56; 95% confidence interval, 0.44 to 0.70; P < 0.001) compared to standard therapy. There were no significant differences in clinical recovery, length of hospital stay or clinical, laboratory and spirometry outcomes in both groups. Number of asthma exacerbations, emergency room visits, hospitalizations and need for corticosteroid use due to asthma were similar during the 12-month follow-up period.
conclusionA PCT-guided strategy allows antibiotic exposure to be reduced in patients with severe acute exacerbation of asthma without apparent harm.
trial registrationChinese Clinical Trial Register ChiCTR-TRC-12002534 (registered 26 September 2012).
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