Trial reportBMC medicine2015
Procalcitonin and pyuria-based algorithm reduces antibiotic use in urinary tract infections: a randomized controlled trial.
Trial report in BMC medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 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, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Non-steroidal anti-inflammatory drugs for treating symptomatic uncomplicated urinary tract infections in non-pregnant adult women.The Cochrane database of systematic reviews · 2024Pooled 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
- Uncomplicated Bacterial Community-Acquired Urinary Tract Infection in Adults.Deutsches Arzteblatt international · 2017Guideline
- Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.The Cochrane database of systematic reviews · 2017Pooled it
- Procalcitonin, mid-regional proadrenomedullin and C-reactive protein in predicting treatment outcome in community-acquired febrile urinary tract infection.BMC infectious diseases · 2019Trial
- Dynamic procalcitonin-guided antibiotic stewardship among cancer patients in the UK.Journal of medical microbiology · 2026Article
- Risk factors for poor prognosis in adult outpatient urinary tract infection: a meta-analysis.BJGP open · 2025Article
- Biomarkers for risk stratification and antibiotic stewardship in elderly patients.Aging clinical and experimental research · 2023Review
- The Diagnostic Accuracy Of Procalcitonin for Urinary Tract Infection in Hospitalized Older Adults: a Prospective Study.Journal of general internal medicine · 2022Article
- 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
- Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections.Antibiotics (Basel, Switzerland) · 2022Review
- Sensitivity of C-Reactive Protein and Procalcitonin Measured by Point-of-Care Tests to Diagnose Urinary Tract Infections in Nursing Home Residents: A Cross-Sectional Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Article
- Evidence-Informed Practice: Diagnostic Questions in Urinary Tract Infections in the Elderly.The western journal of emergency medicine · 2019Review
- Comparison of the novel ARCHITECT procalcitonin assay with established procalcitonin assay systems.Practical laboratory medicine · 2018Article
- Procalcitonin-guided diagnosis and antibiotic stewardship revisited.BMC medicine · 2017Review
- Ability of procalcitonin to diagnose bacterial infection and bacteria types compared with blood culture findings.International journal of general medicine · 2016Article
- Article
Corrections and comments
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Authors and funding
22 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrinary tract infections (UTIs) are common drivers of antibiotic use. The minimal effective duration of antibiotic therapy for UTIs is unknown, but any reduction is important to diminish selection pressure for antibiotic resistance, costs, and drug-related side-effects. The aim of this study was to investigate whether an algorithm based on procalcitonin (PCT) and quantitative pyuria reduces antibiotic exposure.
methodsFrom April 2012 to March 2014, we conducted a factorial design randomized controlled open-label trial. Immunocompetent adults with community-acquired non-catheter-related UTI were enrolled in the emergency department of a tertiary-care 600-bed hospital in northwestern Switzerland. Clinical presentation was used to guide initiation and duration of antibiotic therapy according to current guidelines (control group) or with a PCT-pyuria-based algorithm (PCT-pyuria group). The primary endpoint was overall antibiotic exposure within 90 days. Secondary endpoints included duration of the initial antibiotic therapy, persistent infection 7 days after end of therapy and 30 days after enrollment, recurrence and rehospitalizations within 90 days.
resultsOverall, 394 patients were screened, 228 met predefined exclusion criteria, 30 declined to participate, and 11 were not eligible. Of these, 125 (76% women) were enrolled in the intention-to-treat (ITT) analysis and 96 patients with microbiologically confirmed UTI constituted the per protocol group; 84 of 125 (67%) patients had a febrile UTI, 28 (22%) had bacteremia, 5 (4%) died, and 3 (2%) were lost to follow-up. Overall antibiotic exposure within 90 days was shorter in the PCT-pyuria group than in the control group (median 7.0 [IQR, 5.0-14.0] vs. 10.0 [IQR, 7.0-16.0] days, P = 0.011) in the ITT analysis. Mortality, rates of persistent infections, recurrences, and rehospitalizations were not different.
conclusionsA PCT-pyuria-based algorithm reduced antibiotic exposure by 30% when compared to current guidelines without apparent negative effects on clinical outcomes.
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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.