AB duration in CAP

A patient with community-acquired pneumonia (CAP) will usually be treated with antibiotics (AB) for 7-14 days.

It has now been demonstrated that the duration of therapy can be specifically guided for each patient by monitoring the development of Procalcitonin (PCT) concentration over the course of antibiotic treatment. Thus, having decided on a PCT-based AB guided therapy PCT values will be closely monitored. It is recommended that AB therapy conclude when PCT levels fall below 80-90% of peak value and it is strongly recommended that AB therapy conclude when PCT levels fall below 0,1 µg/L.

Consequently, with PCT guidance the duration of antibiotic therapy could be reduced by several days (Figure below) with similar outcome for both groups.

pct guidance prohosp

Medical and economic impact

Therefore the integration of Procalcitonin (PCT) into diagnostic and treatment algorithms allows both an earlier treatment and also more targeted use of clinical and financial resources by:

  • reducing expenditure on antibiotics
  • reducing the number of treatment days

This PCT-based decision algorithm allows the tailoring of the duration of therapy to the individual clinical situation of each patient, so that total AB use will be strictly limited according to their specific clinical needs.

 

References:

Christ-Crain M et al. Am J Respir Crit Care Med. 2006 Apr 7; [Epub ahead of print, doi:10.1164/rccm.200512-1922OC]
Schuetz P et al. JAMA. 2009;302(10):1059-1066
Schuetz P et al. Expert Rev. Anti Infect. Ther. 8(5), 575–587 (2010)
Stolz D et al. Eur Respir J 2009; 34: 1364–1375

 

thermo scientific applied biosystems invitrogen fisher scientific unity lab service