Idioma:

Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials

Heilmann, Eva ; Gregoriano, Claudia ; Annane, Djillali ; Reinhart, Konrad ; Bouadma, Lila ; Wolff, Michel ; Chastre, Jean ; Luyt, Charles-Edouard ; Tubach, Florence ; Branche, Angela R ; Briel, Matthias ; Christ-Crain, Mirjam ; Welte, Tobias ; Corti, Caspar ; de Jong, Evelien ; Nijsten, Maarten ; de Lange, Dylan W ; van Oers, Jos A H ; Beishuizen, Albertus ; Girbes, Armand R J ; Deliberato, Rodrigo O ; Schroeder, Stefan ; Kristoffersen, Kristina B ; Layios, Nathalie ; Damas, Pierre ; Lima, Stella S S ; Nobre, Vandack ; Wei, Long ; Oliveira, Carolina F ; Shehabi, Yahya ; Stolz, Daiana ; Tamm, Michael ; Verduri, Alessia ; Wang, Jin-Xiang ; Drevet, Sabine ; Gavazzi, Gaetan ; Mueller, Beat ; Schuetz, Philipp

2021-09

Texto completo disponível

Citações Citado por

Enviar para

Título:
Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials
Autor: Heilmann, Eva ; Gregoriano, Claudia ; Annane, Djillali ; Reinhart, Konrad ; Bouadma, Lila ; Wolff, Michel ; Chastre, Jean ; Luyt, Charles-Edouard ; Tubach, Florence ; Branche, Angela R ; Briel, Matthias ; Christ-Crain, Mirjam ; Welte, Tobias ; Corti, Caspar ; de Jong, Evelien ; Nijsten, Maarten ; de Lange, Dylan W ; van Oers, Jos A H ; Beishuizen, Albertus ; Girbes, Armand R J ; Deliberato, Rodrigo O ; Schroeder, Stefan ; Kristoffersen, Kristina B ; Layios, Nathalie ; Damas, Pierre ; Lima, Stella S S ; Nobre, Vandack ; Wei, Long ; Oliveira, Carolina F ; Shehabi, Yahya ; Stolz, Daiana ; Tamm, Michael ; Verduri, Alessia ; Wang, Jin-Xiang ; Drevet, Sabine ; Gavazzi, Gaetan ; Mueller, Beat ; Schuetz, Philipp
Assuntos: age ; Aged ; Ageing ; Algorithms ; Anti-Bacterial Agents/adverse effects ; antibiotic stewardship ; Geriatrics and Gerontology ; Humans ; Intensive Care Units ; Meta-Analysis ; older patients ; Procalcitonin ; Randomized Controlled Trials as Topic ; Research Support, Non-U.S. Gov't
Notas: 0002-0729
https://dspace.library.uu.nl/handle/1874/444000
Age and ageing 50(5), 1546-1556 (2021)
Descrição: BACKGROUND: Older patients have a less pronounced immune response to infection, which may also influence infection biomarkers. There is currently insufficient data regarding clinical effects of procalcitonin (PCT) to guide antibiotic treatment in older patients. OBJECTIVE AND DESIGN: We performed an individual patient data meta-analysis to investigate the association of age on effects of PCT-guided antibiotic stewardship regarding antibiotic use and outcome. SUBJECTS AND METHODS: We had access to 9,421 individual infection patients from 28 randomized controlled trials comparing PCT-guided antibiotic therapy (intervention group) or standard care. We stratified patients according to age in four groups (<75 years [n = 7,079], 75-80 years [n = 1,034], 81-85 years [n = 803] and >85 years [n = 505]). The primary endpoint was the duration of antibiotic treatment and the secondary endpoints were 30-day mortality and length of stay. RESULTS: Compared to control patients, mean duration of antibiotic therapy in PCT-guided patients was significantly reduced by 24, 22, 26 and 24% in the four age groups corresponding to adjusted differences in antibiotic days of -1.99 (95% confidence interval [CI] -2.36 to -1.62), -1.98 (95% CI -2.94 to -1.02), -2.20 (95% CI -3.15 to -1.25) and - 2.10 (95% CI -3.29 to -0.91) with no differences among age groups. There was no increase in the risk for mortality in any of the age groups. Effects were similar in subgroups by infection type, blood culture result and clinical setting (P interaction >0.05). CONCLUSIONS: This large individual patient data meta-analysis confirms that, similar to younger patients, PCT-guided antibiotic treatment in older patients is associated with significantly reduced antibiotic exposures and no increase in mortality.
Data de criação/publicação: 2021-09
Idioma: Inglês

Voltar para lista de resultados

Realização: Logos de Redes Sociais:

Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials

2021-09

Buscando em bases de dados remotas. Favor aguardar.