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

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  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS ONE Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
    • 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.
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    • Accession Number:
      0 (Anti-Bacterial Agents)
      0 (Procalcitonin)
    • Publication Date:
      Date Created: 20190919 Date Completed: 20200311 Latest Revision: 20200311
    • Publication Date:
      20200527
    • Accession Number:
      PMC6750599
    • Accession Number:
      10.1371/journal.pone.0220686
    • Accession Number:
      31532769
  • 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. e0220686, 2019. DOI 10.1371/journal.pone.0220686. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mnh&AN=31532769. 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):e0220686. doi:10.1371/journal.pone.0220686
    • 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), e0220686. https://doi.org/10.1371/journal.pone.0220686
    • 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): e0220686. doi:10.1371/journal.pone.0220686.
    • 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. e0220686. doi: 10.1371/journal.pone.0220686.
    • 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. e0220686, 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. e0220686. EBSCOhost, doi:10.1371/journal.pone.0220686.
    • 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): e0220686. doi:10.1371/journal.pone.0220686.
    • 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):e0220686. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mnh&AN=31532769