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Guideline Reduces Antibiotics Usage, Adverse Drug Effects

Last Updated: September 08, 2009.

In the management of lower respiratory tract infections, procalcitonin-based guidelines may lead to lower rates of antibiotic exposure and associated adverse effects without increasing adverse outcomes, according to a study published in the Sept. 9 issue of the Journal of the American Medical Association.

TUESDAY, Sept. 8 (HealthDay News) -- In the management of lower respiratory tract infections, procalcitonin-based guidelines may lead to lower rates of antibiotic exposure and associated adverse effects without increasing adverse outcomes, according to a study published in the Sept. 9 issue of the Journal of the American Medical Association.

Philipp Schuetz, M.D., of Kantonsspital Aarau in Switzerland, and colleagues randomly assigned 1,359 patients to antibiotics administration with either a procalcitonin algorithm or to standard guidelines for stopping and starting antibiotics.

Compared to standard guidelines, the researchers found that the procalcitonin algorithm was associated with a significantly lower mean duration of antibiotics exposure (5.7 versus 8.7 days) and a lower rate of antibiotic-associated adverse effects (19.8 versus 28.1 percent). They also found that there was no significant difference in the rates of adverse outcomes (15.4 versus 18.9 percent).

"Schuetz and colleagues have charted the waters for more tailored management of lower respiratory tract infections by demonstrating that a procalcitonin-guided decision rule safely diminishes antibiotic use and adverse effects in patients in such illnesses," state the authors of an accompanying editorial. "In the future, an increasing number of such 'theragnostic' approaches are likely to be possible in which blood samples or tissue specimens can be used to quickly measure microbial fragments, circulating markers of organ stress and system responses, and genetic patterns that predict clinical outcomes, drug effectiveness, or both."

Several authors of the study and one of the authors of the editorial reported financial relationships with BRAHMS Inc., the manufacturer of the procalcitonin assay.

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