Observational studyJournal of the Pediatric Infectious Diseases Society2017
A Pragmatic Biomarker-Driven Algorithm to Guide Antibiotic Use in the Pediatric Intensive Care Unit: The Optimizing Antibiotic Strategies in Sepsis (OASIS) Study.
Observational study in Journal of the Pediatric Infectious Diseases Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed, 35 citations in OpenAlex.
- Article
- Role of biomarkers in pediatric sepsis: What evidence says?World journal of clinical pediatrics · 2026Review
- Personalized Interpretation of CBC and the Role of CRP in Early Detection and Monitoring of Blood Infection or Sepsis: A Diagnostic Perspective.Health science reports · 2026Article
- Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Association between serum procalcitonin levels and outcomes of patients admitted to two tertiary paediatric intensive care units in Bloemfontein: A retrospective analytical study.The Southern African journal of critical care : the official journal of the Critical Care Society · 2025Article
- Diagnostic utility of acute phase proteins and their ability to guide antibiotic usage in pigs, horses, and cattle: a mapping review.Acta veterinaria Scandinavica · 2024Review
- Article
- Real-World Application of a Procalcitonin Monitoring Protocol in a Pediatric Intensive Care Unit.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
- Risk of Mortality in Immunocompromised Children With Severe Sepsis and Septic Shock.Critical care medicine · 2020Article
- Utility of Procalcitonin as a Biomarker for Sepsis in Children.Journal of clinical microbiology · 2020Review
- Implementation of a Pragmatic Biomarker-Driven Algorithm to Guide Antibiotic Use in the Pediatric Intensive Care Unit: the Optimizing Antibiotic Strategies in Sepsis (OASIS) II Study.Journal of the Pediatric Infectious Diseases Society · 2020Article
- Agreement Between Two Procalcitonin Assays in Hospitalized Children.Infectious diseases and therapy · 2019Article
- Point-of-care testing for procalcitonin in identifying bacterial infections in young infants: a diagnostic accuracy study.BMC pediatrics · 2018Observational
- Viral Sepsis in Children.Frontiers in pediatrics · 2018Review
- How Can We Optimize Antibiotic Use in the PICU?Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2017Article
- Biomarker-guided antibiotic therapy-strengths and limitations.Annals of translational medicine · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND.: Biomarkers that identify critically ill children with systemic inflammatory response syndrome (SIRS) at low risk for bacterial infection may help clinicians reduce unnecessary antibiotic use. METHODS.: We conducted a prospective cohort study of children with SIRS and suspected infection admitted to a pediatric intensive care unit from January 5, 2012 to March 7, 2014. We enrolled patients upon initiation of new antibiotics (Time 0) and measured a panel of 8 serum biomarkers daily over 72 hours. Microbiology, imaging, and clinical data were reviewed to classify bacterial infections using Centers for Disease Control and Prevention definitions. We identified cut points of biomarker combinations to maximize the negative predictive value (NPV) and specificity for bacterial infection. Excess antibiotics were calculated as days of therapy beyond day 2 after SIRS onset in patients without bacterial infection. RESULTS.: Infections were identified in 46 of 85 patients: bacterial (n = 22) and viral (24), whereas 39 patients had no infection identified. At Time 0, C-reactive protein (CRP) <5 mg/dL plus serum amyloid A <15.0 µg/mL had an NPV of 0.92 (95% confidence interval [CI], 0.79-1.0) and specificity of 0.54 (95% CI, 0.42-0.66) to identify patients without bacterial infection, whereas CRP <4 mg/dL plus procalcitonin <1.75 ng/mL had an NPV of 0.90 (95% CI, 0.79-1.0) and specificity of 0.43 (95% CI, 0.30-0.55). Patients without bacterial infection received a mean of 3.8 excess days of therapy. CONCLUSIONS.: Early measurement of select biomarkers can identify children with SIRS in whom antibiotics might be safely discontinued when there is no other objective evidence of infection at 48 hours.
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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.