Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study.

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  • Additional Information
    • Publication Year:
      2019
    • Author-Supplied Keywords:
      Antibiotics
      Antimicrobials
      Bacterial diseases
      Biology and life sciences
      Drugs
      Health care
      Health care facilities
      Hospitals
      Infectious diseases
      Intensive care units
      Medicine and health sciences
      Microbial control
      Microbiology
      Nosocomial infections
      Pediatric infections
      Pediatric surgery
      Pediatrics
      Pharmacology
      Pulmonology
      Research Article
      Respiratory infections
      Surgical and invasive medical procedures
    • NAICS/Industry Codes:
      NAICS/Industry Codes 621498 All Other Outpatient Care Centers
    • Abstract:
      Introduction and objective: Children admitted to the pediatric intensive care unit after cardiovascular surgery usually require treatment with antibiotics due to suspicion of infection. The aim of this study was to assess the effectiveness of procalcitonin in decreasing the duration of antibiotic treatment in children after cardiovascular surgery. Methods: Prospective, interventional study carried out in a pediatric intensive care unit. Included patients under 18 years old admitted after cardiopulmonary bypass. Two groups were compared, depending on the implementation of the PCT-guided protocol to stop or de-escalate the antibiotic treatment (Group 1, 2011–2013 and group 2, 2014–2018). This new protocol was based on the decrease of the PCT value by 20% or 50% with respect to the maximum value of PCT. Primary endpoints were mortality, stewardship indication, duration of antibiotic treatment, and antibiotic-free days. Results: 886 patients were recruited. There were 226 suspicions of infection (25.5%), and they were confirmed in 38 cases (16.8%). The global rate of infections was 4.3%. 102 patients received broad-spectrum antibiotic (4.7±1.7 days in group 1, 3.9±1 days in group 2 with p = 0.160). The rate of de-escalation was higher in group 2 (30/62, 48.4%) than in group 1 (24/92, 26.1%) with p = 0.004. A reduction of 1.1 days of antibiotic treatment (group 1, 7.7±2.2 and group 2, 6.7±2.2, with p = 0.005) and 2 more antibiotic free-days free in PICU in group 2 were observed (p = 0.001), without adverse outcomes. Conclusions: Procalcitonin-guided protocol for stewardship after cardiac surgery seems to be safe and useful to decrease the antibiotic exposure. This protocol could help to reduce the duration of broad-spectrum antibiotics and the duration of antibiotics in total, without developing complications or adverse effects. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • ISSN:
      19326203
    • Accession Number:
      138684412
  • Citations
    • ABNT:
      BOBILLO-PEREZ, S. et al. Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study. PLoS ONE, [s. l.], v. 14, n. 9, p. 1, 2019. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412. Acesso em: 13 ago. 2020.
    • AMA:
      Bobillo-Perez S, Sole-Ribalta A, Balaguer M, et al. Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study. PLoS ONE. 2019;14(9):1. Accessed August 13, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412
    • APA:
      Bobillo-Perez, S., Sole-Ribalta, A., Balaguer, M., Esteban, E., Girona-Alarcon, M., Hernandez-Platero, L., Segura, S., Felipe, A., Cambra, F. J., Launes, C., & Jordan, I. (2019). Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study. PLoS ONE, 14(9), 1.
    • Chicago/Turabian: Author-Date:
      Bobillo-Perez, Sara, Anna Sole-Ribalta, Monica Balaguer, Elisabeth Esteban, Monica Girona-Alarcon, Lluisa Hernandez-Platero, Susana Segura, et al. 2019. “Procalcitonin to Stop Antibiotics after Cardiovascular Surgery in a Pediatric Intensive Care Unit—The PROSACAB Study.” PLoS ONE 14 (9): 1. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412.
    • Harvard:
      Bobillo-Perez, S. et al. (2019) ‘Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study’, PLoS ONE, 14(9), p. 1. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412 (Accessed: 13 August 2020).
    • Harvard: Australian:
      Bobillo-Perez, S, Sole-Ribalta, A, Balaguer, M, Esteban, E, Girona-Alarcon, M, Hernandez-Platero, L, Segura, S, Felipe, A, Cambra, FJ, Launes, C & Jordan, I 2019, ‘Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study’, PLoS ONE, vol. 14, no. 9, p. 1, viewed 13 August 2020, .
    • MLA:
      Bobillo-Perez, Sara, et al. “Procalcitonin to Stop Antibiotics after Cardiovascular Surgery in a Pediatric Intensive Care Unit—The PROSACAB Study.” PLoS ONE, vol. 14, no. 9, Sept. 2019, p. 1. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412.
    • Chicago/Turabian: Humanities:
      Bobillo-Perez, Sara, Anna Sole-Ribalta, Monica Balaguer, Elisabeth Esteban, Monica Girona-Alarcon, Lluisa Hernandez-Platero, Susana Segura, et al. “Procalcitonin to Stop Antibiotics after Cardiovascular Surgery in a Pediatric Intensive Care Unit—The PROSACAB Study.” PLoS ONE 14, no. 9 (September 18, 2019): 1. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412.
    • Vancouver/ICMJE:
      Bobillo-Perez S, Sole-Ribalta A, Balaguer M, Esteban E, Girona-Alarcon M, Hernandez-Platero L, et al. Procalcitonin to stop antibiotics after cardiovascular surgery in a pediatric intensive care unit—The PROSACAB study. PLoS ONE [Internet]. 2019 Sep 18 [cited 2020 Aug 13];14(9):1. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=138684412