[Biomarker guided antibiotic stewardship in community acquired pneumonia].

Q4 Medicine

Nederlands tijdschrift voor geneeskunde Pub Date : 2025-05-14

Ruud Duijkers, Marc J M Bonten, Wim G Boersma

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引用次数: 0

Abstract

Objective: To investigate whether the duration of antibiotic therapy in patients with CAP can be reduced using a biomarker-guided algorithm.

Design: Randomized controlled multicentre study.

Method: A total of 468 non-ICU patients with CAP were randomized after 2-3 days into three groups (ratio 1:1:1): standard treatment, PCT-guided treatment, and CRP-guided treatment. The primary outcome was the total number of days on antibiotic treatment until day 30. Secondary outcomes included new antibiotic prescriptions, time to clinical stability, length of hospital stay, and 30-day mortality.

Results: The mean age of 468 participants was 67 years, and a potential pathogen was identified in 64% of cases. The total number of days on antibiotic treatment was reduced by 30% in the CRP group (4 vs. 7 days; p < 0.001) and by 22% in the PCT group (5.5 vs. 7 days; p < 0.001). No significant differences were observed in secondary outcomes between the standard treatment and biomarker-guided treatment groups.

Conclusion: Both CRP- and PCT-guided algorithms reduce the duration of antibiotic use in non-ICU patients with CAP. No differences were observed between the three groups in terms of additional antibiotic prescriptions, length of hospital stay, or mortality.

本刊更多论文

[生物标志物引导的社区获得性肺炎抗生素管理]。

目的：探讨生物标志物引导算法是否可以缩短CAP患者的抗生素治疗时间。设计：随机对照多中心研究。方法：将468例非icu CAP患者于术后2 ~ 3 d随机分为标准治疗组、pct引导治疗组、crp引导治疗组（比例1:1:1）。主要结果是抗生素治疗的总天数，直到第30天。次要结局包括新的抗生素处方、临床稳定时间、住院时间和30天死亡率。结果：468名参与者的平均年龄为67岁，64%的病例中发现潜在病原体。CRP组抗生素治疗的总天数减少了30%(4天vs. 7天；p < 0.001)， PCT组减少22% (5.5 vs. 7天；P < 0.001)。在标准治疗组和生物标志物引导治疗组之间，次要结局无显著差异。结论：CRP和pct引导的算法都减少了非icu CAP患者的抗生素使用时间。在额外抗生素处方、住院时间或死亡率方面，三组之间没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nederlands tijdschrift voor geneeskunde Medicine-Medicine (all)

CiteScore

0.30

自引率

0.00%

发文量

302

期刊介绍： Het NTVG staat bekend als hét wetenschappelijke algemene medische tijdschrift. De lange historie en de degelijkheid maken het tijdschrift tot een bolwerk van medische wetenschap in druk. Ook door de goede leesbaarheid draagt het tijdschrift bij aan de voortdurende dialoog over de geneeskunde.