SynthesisAnaesthesia2026
Clinical effectiveness of procalcitonin- or C-reactive protein-guided antibiotic discontinuation protocols for adult patients who are critically ill with sepsis: a rapid systematic review and meta-analysis.
Synthesis in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.
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
4 citing papers in PubMed.
- Article
- Article
- Identification of MMP8, DDX24, RNASE2, and EMB as a novel diagnostic gene panel for sepsis: a transcriptome-based modeling study.Frontiers in immunology · 2026Article
- Shengmai Injection as adjunctive therapy in sepsis and septic shock: a retrospective cohort study.Frontiers in cellular and infection microbiology · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
Abstract
introductionAntibiotics are a first-line treatment for sepsis, with guidelines recommending a 7- to 10-day course. Prolonged antibiotic use carries significant risks, prompting growing interest in using inflammatory biomarkers, such as procalcitonin or C-reactive protein, to guide clinical decision-making on the duration of antibiotic therapy in patients who are critically ill. This rapid systematic review aims to assess the effectiveness and safety of using procalcitonin- or C-reactive protein-guided protocols for antibiotic discontinuation in patients who are critically ill with sepsis.
methodsWe conducted systematic searches for articles published after January 2005 in relevant databases. Eligible studies included randomised controlled trials comparing procalcitonin- or C-reactive protein-guided protocols for antibiotic discontinuation with standard care, or with each other. Primary outcomes were duration of antibiotic therapy and mortality. Secondary outcomes included infection recurrences; secondary infections or superinfections; and the duration of intensive care and hospital stays.
resultsWe identified 21 eligible studies. Moderate certainty evidence from 19 trials, involving 6382 patients, indicated that procalcitonin-guided protocols probably reduced antibiotic therapy by, on average, 2.0 days (95%CI -2.6 to -1.4) compared with standard care. Moderate certainty evidence from 18 trials, involving 6228 patients, suggested an average 5% reduction in mortality risk when using procalcitonin-guided protocols compared with standard care (risk ratio 0.95, 95%CI 0.83-1.07). The evidence regarding C-reactive protein-guided protocols versus standard care approaches remained unclear, with very low to low certainty evidence available. DISCUSSION: Combining relevant trials suggests that procalcitonin-guided discontinuation protocols may be both safe and effective for patients who are critically ill with sepsis, with no increased risk in mortality. In contrast, the evidence supporting C-reactive protein-guided protocols is limited. These findings underscore the potential importance of utilising procalcitonin to inform antimicrobial stewardship practices, particularly in critical care settings.
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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.