SynthesisChest2019
Procalcitonin-Guided Antibiotic Discontinuation and Mortality in Critically Ill Adults: A Systematic Review and Meta-analysis.
Synthesis in Chest, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 3 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Pooled it
- Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy versus Standard of Care for Sepsis: A Systematic Review and Meta-Analysis.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026Pooled it
- A genome- and phenome-wide association study of plasma procalcitonin concentrations in individuals of European ancestry.EBioMedicine · 2026Pooled it
- Lung ultrasound and procalcitonin, improving antibiotic management and avoiding radiation exposure in pediatric critical patients with bacterial pneumonia: a randomized clinical trial.European journal of medical research · 2024Trial
- Impact of Point-of-Care Rapid Diagnostic Tests on Antibiotic Prescription Among Patients Aged <18 Years in Primary Healthcare Settings in 2 Peri-Urban Districts in Ghana: Randomized Controlled Trial Results.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Procalcitonin and Interleukin-10 May Assist in Early Prediction of Bacteraemia in Children With Cancer and Febrile Neutropenia.Frontiers in immunology · 2021Trial
- Procalcitonin and lung ultrasound algorithm to diagnose severe pneumonia in critical paediatric patients (PROLUSP study). A randomised clinical trial.Respiratory research · 2020Trial
- Duration of antibiotic therapy in critically ill patients: a randomized controlled trial of a clinical and C-reactive protein-based protocol versus an evidence-based best practice strategy without biomarkers.Critical care (London, England) · 2020Trial
- The PRECISE framework: a structured approach to antibiogram interpretation for antimicrobial optimization at the bedside.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Integration of the National Early Warning Score 2 and the procalcitonin-to-albumin ratio for sepsis prediction in patients with pyogenic liver abscess: a retrospective cohort study.BMC infectious diseases · 2026Article
- Clinical Impact of Droplet Digital PCR-Guided Antibiotic Stewardship on Prognosis in Patients with Suspected Bloodstream Infection: A Prospective Observational Study.Infectious diseases and therapy · 2026Article
- Postoperative Antibiotic Escalation After Major Free-Flap Reconstruction Requiring ICU Admission: Associations with Day-1 Procalcitonin, Shock, and Microbiological Positivity.Life (Basel, Switzerland) · 2026Article
- Duration Matters: Tailoring Antibiotic Therapy for Ventilator-Associated Pneumonia.Antibiotics (Basel, Switzerland) · 2026Review
- Bug Wars: Artificial Intelligence Strikes Back in Sepsis Management.Diagnostics (Basel, Switzerland) · 2025Review
- Geriatric-Specific Considerations in the Care of Older Adults with Pulmonary/Respiratory Diseases.Emergency medicine clinics of North America · 2025Review
- Article
- Does serial procalcitonin monitoring predict clinical outcomes in children with sepsis? A diagnostic stewardship study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Biomarkers in pulmonary infections: a clinical approach.Annals of intensive care · 2024Review
- The Clinical Pulmonary Infection Score Combined with Procalcitonin and Lung Ultrasound (CPIS-PLUS), a Good Tool for Ventilator Associated Pneumonia Early Diagnosis in Pediatrics.Children (Basel, Switzerland) · 2024Article
- Optimizing Diagnosis and Management of Community-acquired Pneumonia in the Emergency Department.Emergency medicine clinics of North America · 2024Review
3 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundProcalcitonin (PCT)-guided antibiotic discontinuation appears to decrease antibiotic use in critically ill patients, but its impact on survival remains less certain.
methodsWe searched PubMed, Embase, Scopus, Web of Science, and CENTRAL for randomized controlled trials (RCTs) of PCT-guided antibiotic discontinuation in critically ill adults reporting survival or antibiotic duration. Searches were conducted without language restrictions from inception to July 23, 2018. Two reviewers independently conducted all review stages; another adjudicated differences. Data were pooled using random-effects meta-analysis. Study quality was assessed with the Cochrane risk of bias tool, and evidence was graded using GRADEpro.
resultsAmong critically ill adults (5,158 randomized; 5,000 analyzed), PCT-guided antibiotic discontinuation was associated with decreased mortality (16 RCTs; risk ratio [RR], 0.89; 95% CI, 0.83-0.97; I
conclusionsOur findings of increased survival and decreased antibiotic utilization associated with PCT-guided antibiotic discontinuation represent low-certainty evidence with a high risk of bias. This relationship was primarily observed in studies without high protocol adherence and in studies with algorithms combining PCT and C-reactive protein. Properly designed studies with mortality as the primary outcome are needed to address this question. TRIAL REGISTRY: International Prospective Register of Systematic Reviews (PROSPERO); No.: CRD42016049715; URL: http://www.crd.york.ac.uk/PROSPERO_REBRANDING/display_record.asp?ID=CRD42016049715.
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.