Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pro/Con debate: Is procalcitonin useful for guiding antibiotic decision making in critically ill patients? | Available online http content 12 3 211 Review Pro Con debate Is procalcitonin useful for guiding antibiotic decision making in critically ill patients Yahya Shehabi1 and Ian Seppelt2 1Acute Care Clinical Program Intensive Care and Research Prince of Wales Hospital University of New South Wales Barker Street Randwick NSW 2031 Australia 2Department of Intensive Care Medicine Nepean Hospital University of Sydney Derby Street Penrith NSW 2751 Australia Corresponding author Yahya Shehabi Published 2 May 2008 This article is online at http content 12 3 211 2008 BioMed Central Ltd Critical Care 2008 12 211 doi cc6860 Abstract You are concerned about the escalating use of antibiotics in your intensive care unit ICU . This has put a strain on the ICU budget and is possibly resulting in the emergence of resistant bacteria. You review the situation with your team and one suggestion is to consider using biomarkers such as procalcitonin to better guide appropriate antibiotic decision making. Pro Time for goal-directed procalcitonin-guided antibiotic therapy in the intensive care unit More than 40 of the patients in European and Australasian intensive care units ICUs have sepsis or severe sepsis but only 58 of clinically suspected infections are confirmed by positive culture 1 . While it is perfectly justifiable to commence broad-spectrum antibiotics early the decision to continue or cease such therapy remains an arbitrary one by the treating intensivist. This can lead to the indiscriminate overuse of antimicrobials with significant cost implications and of far greater concern increasingly frequent outbreaks of resistant organisms 2 . Procalcitonin is a SMART biomarker for sepsis and infection While fever leukocytosis and other responses to systemic inflammation are clinical signs consistent with sepsis and infection 3 they are neither specific nor sensitive to guide antibiotic therapy at any stage during sepsis management. A
