Acta clinica Croatica, Vol. 62. No. 1, 2023.
Izvorni znanstveni članak
https://doi.org/10.20471/acc.2023.62.01.05
Procalcitonin Guided Antibiotic Stewardship: A Balkan Expert Consensus Statement
Radmilo Janković
; University Clinical Center Niš, Department of Anesthesia and Intensive Therapy, Faculty of Medicine, University of Niš, Niš, Serbia
Milena Stojanović
; University Clinical Center Niš, Department of Anesthesia and Intensive Therapy, Faculty of Medicine, University of Niš, Niš, Serbia
Hristo Božov
; Department of Anesthesiology, Maritime and Intensive Medicine, Naval Hospital, Varna, Bulgaria
Rudin Domi
; University of Medicine, Tirana Faculty of Medicine, Tirana, Albania
Višnja Ivančan
; Zagreb University Hospital Center, Zagreb, Croatia
Marijana Karišik
; Department of Anesthesiology and Intensive Care, Institute for Children’s Disease, Clinical Center of Montenegro, Podgorica, Montenegro
Maja Mojsova Mijovska
; Department of Anesthesia, Resuscitation and Intensive Care (KARIL), Skopje, North Macedonia
Jasmina Jakupović Smajić
; Tuzla University Clinical Center, Tuzla University, Medical Faculty, Tuzla, Bosnia and Herzegovina
Maja Šoštarič
; Ljubljana University Medical Center, University of Ljubljana, Ljubljana, Slovenia
Sažetak
Sepsis as a consequence of infection is a frequent cause of death among critically
ill patients. The most common sites of infection are lover respiratory tract, abdominal, urinary tract and
catheter-associated blood stream infections. Early empiric, broad-spectrum therapy in those with severe
sepsis and/or shock with the aim of reducing mortality may lead to antibiotic overuse, resistance and
increased costs. Among numerous serum biomarkers, procalcitonin (PCT) has proved to be one of the
most reliable ones in the diagnosis of sepsis. An important means of limiting antibiotic resistance is the
antibiotic stewardship program, especially in intensive care units with critically ill patients and prevalence
of multiple drug-resistant pathogens. The PCT-guided antibiotic stewardship was first started
in Western Europe and Asia-Pacific countries, as well as in the United States. Considering that this
method has proven to be effective in reducing antibiotic consumption while improving clinical outcome,
a group of experts from the Balkan region decided to make their own recommendations and PCT
protocol. When creating this protocol for initiation and duration of antibiotic treatment, they especially
reviewed the literature for lower respiratory tract infection and sepsis. In the protocol, they have included
the severity of illness, clinical assessment, and PCT levels. Developing a consensus on the clinical algorithm
by eminent experts/specialists in various fields of medicine should enable clinicians to use PCT
for initiation of antibiotic therapy and monitoring PCT to stop antibiotics earlier. It is crucial that the
PCT-guided algorithm becomes an integral part of institutional stewardship program.
Ključne riječi
Antibiotic stewardship; Procalcitonin; Respiratory tract infections; Sepsis
Hrčak ID:
307136
URI
Datum izdavanja:
1.4.2023.
Posjeta: 472 *