Serum procalcitonin level for guiding the discontinuation of antibiotics in patients with urinary sepsis

doi:10.3969/j.issn.1673-8640.2018.09.005

Abstract

Abstract:

Objective To investigate the role of serum procalcitonin （PCT） level for guiding the discontinuation of antibiotics in patients with urinary sepsis. Methods A total of 62 patients with urinary sepsis were enrolled and classified into experimental group and control group according to random number table （31 patients for each group）. All patients received antibiotics according to the principle of antimicrobial usage for sepsis. The control group was treated according to the principle of rational antimicrobial usage. The experimental group discontinued antibiotics according to the dynamic changes of serum PCT level. The discontinuation indication was that serum PCT level was ≤0.25 μg/L or serum PCT level had decreased by ≥90% of its peak value. Baseline data,antimicrobial drug use time,intensive care unit （ICU） stay time,total hospitalization time,the recurrence incidence of infection and the infection-related death rate in 28 d were compared between the 2 groups. Results There was no statistical significance in age,sex,complication diseases,acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score and the distribution of infectious bacteria between the 2 groups（P>0.05） with comparability. Antibiotic use time in experimental group was lower than that in control group （P<0.05）. There was no statistical significance for ICU stay time,total hospitalization time,the recurrence incidence of infection and the infection-related death rate in 28 d between the 2 groups （P>0.05）. Conclusions For patients with urinary sepsis,serum PCT level can guide the discontinuation of antibiotics. It could shorten antibiotic use time and could not affect short-term prognosis,which is safe and reliable.

Key words: Procalcitonin, Urinary sepsis, Antibiotic

CLC Number:

R446.5

CHEN Xiaoyan. Serum procalcitonin level for guiding the discontinuation of antibiotics in patients with urinary sepsis[J]. Laboratory Medicine, 2018, 33(9): 794-797.

Figures/Tables 2

References 14

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组别	例数	年龄（岁）		性别（例/%）				病因[例（%）]				入院时体温（℃）		入院时APACHEⅡ评分（分）
组别	例数	年龄（岁）		男性		女性		输尿管结石		单纯输尿管狭窄		入院时体温（℃）		入院时APACHEⅡ评分（分）
实验组	31	53.6±8.2		20（64.5）		11（35.5）		28（90.3）		3（9.7）		39.9±0.8		19.1±3.6
对照组	31	51.9±7.6		19（61.3）		12（38.7）		30（96.8）		1（3.2）		40.1±0.9		20.5±4.1
统计值		0.847		0.069				0.267				1.186		1.429
P值		0.401		0.793				0.605				0.238		0.158
组别	合并基础疾病[例（%）]						感染菌分布[例（%）]
组别	高血压		糖尿病		冠心病		大肠埃希杆菌		铜绿假单胞菌		金黄色葡萄球菌		厌氧菌
实验组	6（19.4）		4（12.9）		2（6.5）		10（32.3）		6（19.4）		11（35.5）		4（12.9）
对照组	5（16.1）		6（19.4）		0（0）		9（29.0）		5（16.1）		12（38.7）		5（16.1）
统计值	0.111		0.477		0.517		0.298
P值	0.740		0.490		0.472		0.960

组别	例数	年龄（岁）		性别（例/%）				病因[例（%）]				入院时体温（℃）		入院时APACHEⅡ评分（分）
组别	例数	年龄（岁）		男性		女性		输尿管结石		单纯输尿管狭窄		入院时体温（℃）		入院时APACHEⅡ评分（分）
实验组	31	53.6±8.2		20（64.5）		11（35.5）		28（90.3）		3（9.7）		39.9±0.8		19.1±3.6
对照组	31	51.9±7.6		19（61.3）		12（38.7）		30（96.8）		1（3.2）		40.1±0.9		20.5±4.1
统计值		0.847		0.069				0.267				1.186		1.429
P值		0.401		0.793				0.605				0.238		0.158
组别	合并基础疾病[例（%）]						感染菌分布[例（%）]
组别	高血压		糖尿病		冠心病		大肠埃希杆菌		铜绿假单胞菌		金黄色葡萄球菌		厌氧菌
实验组	6（19.4）		4（12.9）		2（6.5）		10（32.3）		6（19.4）		11（35.5）		4（12.9）
对照组	5（16.1）		6（19.4）		0（0）		9（29.0）		5（16.1）		12（38.7）		5（16.1）
统计值	0.111		0.477		0.517		0.298
P值	0.740		0.490		0.472		0.960

组别	例数	抗菌药物使用时间（d）	ICU住院时间（d）	总住院时间（d）	28 d内感染复发 [例(%)]	28 d内感染相关死亡 [例(%)]
实验组	31	9.6±3.3	14.9±4.6	25.1±5.8	3（6.5）	3（9.7）
对照组	31	12.0±3.6	17.1±5.5	27.6±6.6	1（3.2）	5（16.1）
t值		2.736	1.708	1.584	0.267	0.144
P值		0.008	0.093	0.118	0.605	0.705

组别	例数	抗菌药物使用时间（d）	ICU住院时间（d）	总住院时间（d）	28 d内感染复发 [例(%)]	28 d内感染相关死亡 [例(%)]
实验组	31	9.6±3.3	14.9±4.6	25.1±5.8	3（6.5）	3（9.7）
对照组	31	12.0±3.6	17.1±5.5	27.6±6.6	1（3.2）	5（16.1）
t值		2.736	1.708	1.584	0.267	0.144
P值		0.008	0.093	0.118	0.605	0.705

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