文章基本信息

标题：Procalcitonin-guided algorithms of antibiotic therapy in the intensive care unit with sepsis: a meta-analysis
本地全文：下载
作者：Yuhan ZHU ; Xiaoxu SHEN ; Yongyao WEN 等
期刊名称：General Internal Medicine and Clinical Innovations
电子版ISSN：2397-5237
出版年度：2018
卷号：3
期号：1
页码：1-11
DOI：10.15761-GIMCI.1000151
语种：English
出版社：Open Access Text
摘要：Objective: To systematically review the effectiveness and safety of antibiotic therapy in sepsis under the guidance of procalcitonin in ICU. Data sources: PubMed, The Cochrane Library (through October 2016), EMbase, Web of Science, reference lists of retrieved publications. No limitations regarding the language of publications. Study selection: We included only randomized controlled studies reporting on critically ill patients with sepsis managed with a PCT-guided algorithm vs. Routine practice. Data extraction: Data on study characteristics, interventions, and outcomes were retrieved by two independent reviewers. Risk ratios, mean differences, and 95% confidence intervals were calculated by implementing both the Mantel-Haenszel fixed effect model and the Mantel-Haenszel random effect model. Data synthesis: Thirteen randomized controlled studies involving 4728 ICU septic patients were included. Compared with the routine particle, PCT-guided algorithms decreased the total duration of antibiotic therapy (REM; MD=-1.60; 95%CI, -2.14 to -1.06; Z=5.79; P0.00001), and the 28-day mortality had also been reduced ((FEM; MD=0.86; 95%CI, 0.76 to 0.97; Z=2.39; P=0.02). However, between the PCT-guided group and the routine practice group, the length of ICU and hospital stay, the ICU mortality, in hospital mortality and the rates of clinical cure had no significant difference. Conclusions: The PCT-guided algorithms could decrease the total duration of antibiotic therapy and reduce the 28-day mortality of septic patients in ICU without improving the length of ICU and hospital stay, the ICU mortality, in hospital mortality and the rates of clinical cure. Further research is still necessary before the wide adoption of this strategy.
关键词：procalcitonin; sepsis; intensive care unit; meta-analysis