ArticleFrontiers in neurology2017
The Randomized Controlled STRAWINSKI Trial: Procalcitonin-Guided Antibiotic Therapy after Stroke.
Article in Frontiers in neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01264549 (Stroke Adverse Outcome is Associated With Nosocomial Infections), which is not on this map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Stroke Adverse Outcome is Associated With Nosocomial Infections: PCTus- Guided Antibacterial Therapy in Severe Ischemic Stroke Patients
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- European stroke organisation guideline on stroke-associated pneumonia.European stroke journal · 2026Guideline
- 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
- Antibiotic therapy for preventing infections in people with acute stroke.The Cochrane database of systematic reviews · 2018Pooled it
- Inflammatory and stress markers predicting pneumonia, outcome, and etiology in patients with stroke: Biomarkers for predicting pneumonia, functional outcome, and death after stroke.Neurology(R) neuroimmunology & neuroinflammation · 2020Trial
- Selection bias in clinical stroke trials depending on ability to consent.BMC neurology · 2017Trial
- Anti-NMDA-Receptor GluN1 Antibody Serostatus Is Robust in Acute Severe Stroke.Diagnostics (Basel, Switzerland) · 2025Article
- Gut Microbiota, Bacterial Translocation, and Stroke: Current Knowledge and Future Directions.Biomedicines · 2024Review
- From Gut to Brain: Unraveling the Intricate Link Between Microbiome and Stroke.Probiotics and antimicrobial proteins · 2024Review
- Bone Marrow Mesenchymal Stem Cell-Derived Dermcidin-Containing Migrasomes enhance LC3-Associated Phagocytosis of Pulmonary Macrophages and Protect against Post-Stroke Pneumonia.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Stroke-associated infections in patients with and without cancer.Neuro-oncology practice · 2023Article
- The roles and mechanisms of gut microbiome and metabolome in patients with cerebral infarction.Frontiers in cellular and infection microbiology · 2023Review
- Antimicrobial Stewardship Using Biomarkers: Accumulating Evidence for the Critically Ill.Antibiotics (Basel, Switzerland) · 2022Review
- Stroke-associated infection in patients with co-morbid diabetes mellitus is associated with in-hospital mortality.Frontiers in aging neuroscience · 2022Article
- European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia.European stroke journal · 2021Article
- A Panel Comprising Serum Amyloid A, White Blood Cells and Nihss for the Triage of Patients at Low Risk of Post-Stroke Infection.Diagnostics (Basel, Switzerland) · 2021Article
- Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections.Journal of neuroinflammation · 2021Review
- Review
- Stroke Severity, and Not Cerebral Infarct Location, Increases the Risk of Infection.Translational stroke research · 2020Article
- Multilevel omics for the discovery of biomarkers and therapeutic targets for stroke.Nature reviews. Neurology · 2020Review
- Gut Microbiota in Acute Ischemic Stroke: From Pathophysiology to Therapeutic Implications.Frontiers in neurology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 9 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia is among the most common acute complications after stroke and is associated with poor long-term outcome. Biomarkers may help identifying stroke patients at high risk for developing stroke-associated pneumonia (SAP) and to guide early treatment.
aimsThis trial investigated whether procalcitonin (PCT) ultrasensitive (PCTus)-guided antibiotic treatment of SAP can improve functional outcome after stroke.
methodsIn this international, multicenter, randomized, controlled clinical trial with blinded assessment of outcomes, patients with severe ischemic stroke in the middle cerebral artery territory were randomly assigned within 40 h after symptom onset to PCTus-based antibiotic therapy guidance in addition to stroke unit care or standard stroke unit care alone. The primary endpoint was functional outcome at 3 months, defined according to the modified Rankin Scale (mRS) and dichotomized as acceptable (≤4) or unacceptable (≥5). Secondary endpoints included usage of antibiotics, infection rates, days of fever, and mortality. The trial was registered with http://ClinicalTrials.gov (Identifier NCT01264549).
resultsIn the intention-to-treat-analysis based on 227 patients (112 in PCT and 115 in control group), 197 patients completed the 3-month follow-up. Adherence to PCT guidance was 65%. PCT-guided therapy did not improve functional outcome as measured by mRS (odds ratio 0.79; 95% confidence interval 0.45-1.35,
conclusionPCTus-guided antibiotic therapy did not improve functional outcome at 3 months after severe ischemic stroke. PCT is a promising biomarker for early detection of pneumonia and sepsis in acute stroke patients.
Indexed as
Identifiers
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.