SynthesisMedical principles and practice : international journal of the Kuwait University, Health Science Centre2026
Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy versus Standard of Care for Sepsis: A Systematic Review and Meta-Analysis.
Synthesis in Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
objectivesThis systematic review and meta-analysis assesses the efficacy and safety of procalcitonin (PCT)-guided therapy compared to the standard of care in septic patients.
methodsA comprehensive literature search was performed using the Cochrane Library, <ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>, Embase, and MEDLINE, covering studies from their inception to April 2025. RevMan was used to perform a random effects meta-analysis, and forest plots were used to visualize the pooled estimates. The Mantel-Haenszel method was applied to analyze dichotomous outcomes. The inverse variance method was applied to analyze continuous outcomes.
resultsSixteen randomized controlled trials, with a total of 6,885 patients, were included. PCT-guided therapy was associated with significantly improved antibiotic treatment duration (standardized mean difference [SMD] -0.81, 95% confidence interval [CI]: -1.17 to -0.45, I2 97%), duration of mechanical ventilation (SMD -0.47, 95% CI: -0.57 to -0.37, I2 0%), and antibiotic-free days (SMD 0.14, 95% CI: 0.04-0.25, I2 0%). Both groups were comparable in terms of ICU mortality, hospital mortality, 30-day mortality, 90-day mortality, ICU stay, hospital stay, new infection, and clinical recovery. PCT was associated with greater reinfection (risk ratio 1.12, 95% CI: 1.00-1.26, I2 0%).
conclusionPCT-guided therapy was associated with shorter antibiotic treatment duration, though substantial heterogeneity was observed, while mortality outcomes were comparable between groups. Standardized PCT-based protocols are needed to improve consistency and clinical applicability.
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