Professor Yahya Shehabi |
Patients with acute respiratory infections should be tested
for a blood marker for bacterial infection to determine antibiotic treatment,
according to a large international study including researchers at Monash
University.
Published yesterday in The
Lancet ID, an individual patient data analysis from 26 randomised
controlled trials across 12 countries was used to investigate the use of
procalcitonin—a biomarker for bacterial infections—as a tool to improve
decisions about antibiotic therapy.
Acute respiratory infections (ARIs) comprise a large group
of infections including bacterial, viral and from other causes, accounting for
over 10% of global disease burden.
In these patients, “despite their mainly viral cause,
unnecessary antibiotics significantly contribute to bacterial resistance,
medical costs and the risk of drug-related side effects”, said co-author
Professor Yahya Shehabi from Monash University who is also a critical care
physician at Monash Health.
“Blood levels of Procalcitonin (PCT) is negligible in normal
people but rises substantially within hours of bacterial infection and
decreases as patients recovers with appropriate antibiotic therapy.”
Randomised trials evaluated the use of procalcitonin based
algorithms, to guide decision making for antibiotics prescription in acute
respiratory infection.
“Our individual patient meta-analysis, combining high
quality trials using data from 6708 patients showed that the use of
procalcitonin guided algorithms significantly reduced the risk of death by 17%
and treatment failure by 12%.
“It also reduced antibiotic consumption and antibiotic-related
side effects (16.3% versus 22.1%).”
“Our analysis also demonstrated that the benefits for sicker
patients, like those needing intensive care treatment, is more pronounced.”
“Procalcitonin can be
measured in the blood of patients at point of care providing clinicians with on
the spot decision making for individual patients,” said Professor Shehabi, the
only Australian author on the study.
No comments:
Post a Comment