Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions

Yannick Wirz; Angela Branche; Michel Wolff; Tobias Welte; Vandack Nobre; Konrad Reinhart; Ann R. Falsey; Pierre Damas; Albertus Beishuizen; Rodrigo O. Deliberato; Yahya Shehabi; Jens Ulrik S. Jensen; Beat Mueller; Philipp Schuetz

doi:10.1021/acsinfecdis.7b00199

Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions

Yannick Wirz, Angela Branche, Michel Wolff, Tobias Welte, Vandack Nobre, Konrad Reinhart, Ann R. Falsey, Pierre Damas, Albertus Beishuizen, Rodrigo O. Deliberato, Yahya Shehabi, Jens Ulrik S. Jensen, Beat Mueller, Philipp Schuetz^*

^*Corresponding author for this work

Department of Clinical Medicine

11 Citations (Scopus)

Abstract

Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.

Original language	English
Journal	ACS Infectious Diseases
Volume	3
Issue number	12
Pages (from-to)	875-879
DOIs	https://doi.org/10.1021/acsinfecdis.7b00199
Publication status	Published - 2017

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Wirz, Y., Branche, A., Wolff, M., Welte, T., Nobre, V., Reinhart, K., Falsey, A. R., Damas, P., Beishuizen, A., Deliberato, R. O., Shehabi, Y., Jensen, J. U. S., Mueller, B., & Schuetz, P. (2017). Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions. ACS Infectious Diseases, 3(12), 875-879. https://doi.org/10.1021/acsinfecdis.7b00199

Wirz, Y, Branche, A, Wolff, M, Welte, T, Nobre, V, Reinhart, K, Falsey, AR, Damas, P, Beishuizen, A, Deliberato, RO, Shehabi, Y, Jensen, JUS, Mueller, B & Schuetz, P 2017, 'Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions', ACS Infectious Diseases, vol. 3, no. 12, pp. 875-879. https://doi.org/10.1021/acsinfecdis.7b00199

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title = "Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions",

abstract = "Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.",

author = "Yannick Wirz and Angela Branche and Michel Wolff and Tobias Welte and Vandack Nobre and Konrad Reinhart and Falsey, {Ann R.} and Pierre Damas and Albertus Beishuizen and Deliberato, {Rodrigo O.} and Yahya Shehabi and Jensen, {Jens Ulrik S.} and Beat Mueller and Philipp Schuetz",

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doi = "10.1021/acsinfecdis.7b00199",

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AU - Wolff, Michel

AU - Welte, Tobias

AU - Nobre, Vandack

AU - Reinhart, Konrad

AU - Falsey, Ann R.

AU - Damas, Pierre

AU - Beishuizen, Albertus

AU - Deliberato, Rodrigo O.

AU - Shehabi, Yahya

AU - Jensen, Jens Ulrik S.

AU - Mueller, Beat

AU - Schuetz, Philipp

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N2 - Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.

AB - Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.

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Management of Respiratory Infections with Use of Procalcitonin: Moving toward More Personalized Antibiotic Treatment Decisions

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