SynthesisCritical care (London, England)2023
Procalcitonin-guided antibiotic therapy may shorten length of treatment and may improve survival-a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07211620 (KInetics of Procalcitonin to Reduce Unnecessary aNtibiotic Use), which is not on this map. Cited by 40 papers, 4 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.
KInetics of Procalcitonin to Reduce Unnecessary aNtibiotic Use (KIPRUN) - Protocol for a Multi-center, Randomized, Superiority Trial to Compare the Efficacy and Safety of Procalcitonin Kinetics-guided and Absolute Procalcitonin Value-guided Antibiotic Initiation in Reducing Unnecessary Antibiotic Therapy in Critically Ill Patients
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 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
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis.Critical care (London, England) · 2024Pooled it
- Procalcitonin testing combined with NEWS2 evaluation compared with usual care based on NEWS2 for identification of sepsis and antibiotic initiation in the emergency department in England and Wales (PRONTO): a multicentre, randomised, controlled, open-label, phase 3 trial.The Lancet. Respiratory medicine · 2026Trial
- Effectiveness of biomarker-guided duration of antibiotic treatment in children hospitalised with confirmed or suspected bacterial infection: the BATCH RCT.Health technology assessment (Winchester, England) · 2025Trial
- Procalcitonin-Guided Management and Duration of Antibiotic Therapy in Critically Ill Cancer Patients With Sepsis (Pro-Can Study): A Randomized Controlled Trial.Critical care explorations · 2024Trial
- 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
- [Sepsis 2026: diagnosis and treatment].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Review
- Pancreatic Stone Protein in Burns: Clinical Value of Bedside Testing-A Prospective Pilot Study.Diagnostics (Basel, Switzerland) · 2026Article
- Association of procalcitonin levels with multidrug-resistant bloodstream infections: a prospective cohort study.BMC infectious diseases · 2026Article
- Article
- Article
- Interleukin-6 in Daily Use in the Intensive Care Unit: Does It Change the Patients' Outcome and Antimicrobial Prescription? An Explorative Study.Life (Basel, Switzerland) · 2026Article
- 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
- Duration of antibiotic therapy: with or without biomarkers?Acute and critical care · 2026Article
- Severe community-acquired pneumonia: an integral approach.Journal of intensive care · 2026Review
- Postoperative Antibiotic Escalation After Major Free-Flap Reconstruction Requiring ICU Admission: Associations with Day-1 Procalcitonin, Shock, and Microbiological Positivity.Life (Basel, Switzerland) · 2026Article
- Procalcitonin-guided decision and antibiotic treatment duration in late onset sepsis of newborns: multicentre, randomised controlled trial (ProABIS).BMJ medicine · 2026Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundAppropriate antibiotic (AB) therapy remains a challenge in the intensive care unit (ICU). Procalcitonin (PCT)-guided AB stewardship could help optimize AB treatment and decrease AB-related adverse effects, but firm evidence is still lacking. Our aim was to compare the effects of PCT-guided AB therapy with standard of care (SOC) in critically ill patients.
methodsWe searched databases CENTRAL, Embase and Medline. We included randomized controlled trials (RCTs) comparing PCT-guided AB therapy (PCT group) with SOC reporting on length of AB therapy, mortality, recurrent and secondary infection, ICU length of stay (LOS), hospital LOS or healthcare costs. Due to recent changes in sepsis definitions, subgroup analyses were performed in studies applying the Sepsis-3 definition. In the statistical analysis, a random-effects model was used to pool effect sizes.
resultsWe included 26 RCTs (n = 9048 patients) in the quantitative analysis. In comparison with SOC, length of AB therapy was significantly shorter in the PCT group (MD - 1.79 days, 95% CI: -2.65, - 0.92) and was associated with a significantly lower 28-day mortality (OR 0.84, 95% CI: 0.74, 0.95). In Sepsis-3 patients, mortality benefit was more pronounced (OR 0.46 95% CI: 0.27, 0.79). Odds of recurrent infection were significantly higher in the PCT group (OR 1.36, 95% CI: 1.10, 1.68), but there was no significant difference in the odds of secondary infection (OR 0.81, 95% CI: 0.54, 1.21), ICU and hospital length of stay (MD - 0.67 days 95% CI: - 1.76, 0.41 and MD - 1.23 days, 95% CI: - 3.13, 0.67, respectively).
conclusionsPCT-guided AB therapy may be associated with reduced AB use, lower 28-day mortality but higher infection recurrence, with similar ICU and hospital length of stay. Our results render the need for better designed studies investigating the role of PCT-guided AB stewardship in critically ill patients.
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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.