Determination of procalcitonin levels reduces the frequency of prescribing antibiotics in patients with community-acquired pneumonia

Determination of serum procalcitonin hormone levels may reduce unreasonable use of antibiotics in patients with community-acquired pneumonia and shorten the duration of antimicrobial therapy, says report to the 2005 American Thoracic Society International Conference.

In a study involving 300 patients with community-acquired pneumonia, it has been shown that taking into account the level of procalcitonin in blood serum, the duration of antibiotic use can be cut in half - Usual 12 days to 6. In addition, 15% of patients with any conditions would be on antimicrobial therapy, may not receive antibiotics at all after determining the concentration of procalcitonin confirmed the absence of the need for appointment of antibiotics.

Patients with community-acquired pneumonia were randomized into 2 groups: the first received standard antibiotic therapy for 10 to 14 days (n = 101); patients in the second group (n = 99) received treatment taking into account the level of procalcitonin in blood serum. The groups did not differ in their main characteristics before the start of the study.

Patients treated with serum procalcitonin were usually given antibiotics if the hormone concentration was 0.25 mcg / L or higher, although doctors prescribed antibiotics if they thought it necessary.

As the results of the study showed, no difference in clinical, radiological or biological results between patients in the two groups was noted. In addition, mortality in the two groups was approximately 14%.

The concentration of procalcitonin in the blood increases only with bacterial infections that require the appointment of antibiotics. With viral infections, it remains unchanged and antibiotics should not be prescribed. In this regard, it is advisable to determine the concentration of procalcitonin in the blood serum in order to distinguish bacterial infections from viral infections. In addition, it is economically feasible because the study is not expensive.

Perhaps the therapy, which is based on determining the level of procalcitonin in blood serum, will not change the clinical approach to treating infections in the near future, but it is a very interesting study that could be very useful in the future. This is mainly due to the fact that hospitalization and treatment of patients with pneumonia results in huge expenses. However, it should be noted that this is a small study and that other large-scale studies are needed in various patient populations.