EFFICACY AND SAFETY OF PROCALCITONIN GUIDANCE IN REDUCING DURATION OF ANTIBIOTIC TREATMENT IN NEONATAL INTENSIVE CARE UNIT
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Keywords
Procalcitonin, antibiotic therapy, neonatal intensive care unit, antimicrobial stewardship, clinical outcomes
Abstract
Background: Procalcitonin has emerged as a valuable biomarker in guiding antibiotic therapy duration for patients with sepsis, aiding clinicians in optimizing treatment and reducing antibiotic resistance risks.
Objective: To determine the efficacy and safety of procalcitonin guidance in reducing duration of antibiotic treatment in neonatal intensive care unit.
Study design: A cross-sectional study design was used.
Settings: The study was conducted at Department of Pediatrics CMH, Multan From November 2023 to February 2024.
Methods: Neonates included in the study were ≤ 28 days old and required antibiotic therapy for suspected infections. The process of randomization was carried out using computer-generated random numbers. The procalcitonin group received antibiotic therapy guided by procalcitonin levels, whereas the standard group received antibiotic therapy according to prevailing clinical guidelines. Primary outcomes were the duration of hospitalisation in the intensive care unit (ICU) and the length of time antibiotics were administered. The data collected was analysed using IBM SPSS, specifically version 27.0.
Results: The gender distribution was similar between groups: females were 44.8% (Procalcitonin) and 45.9% (Standard), and males were 55.2% (Procalcitonin) and 54.1% (Standard). Mean gestational age was 38.31 ± 2.41 weeks (Procalcitonin) and 38.08 ± 2.03 weeks (Standard). ICU stay was shorter in Procalcitonin (9.88 ± 4.83 days) vs. Standard (11.3 ± 3.68 days), p=0.002. Antibiotic duration was shorter in Procalcitonin (5.91 ± 2.99 days) vs. Standard (7.28 ± 3.26 days), p<0.001. Procalcitonin mortality was lower (16.0%) vs. Standard (27.4%), p=0.013. Reinfection rates were similar: Procalcitonin (10.4%) vs. Standard (8.9%), p=0.648. Antibiotic complications were comparable: Procalcitonin (2.5%) vs. Standard (4.5%), p=0.325.
Conclusion: In conclusion, our study supports the use of a serum procalcitonin-based algorithm in critically ill neonates, demonstrating reductions in antibiotic duration, ICU stay, and secondary infection rates
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Dr. Samiah Mazhar
MBBS, PGR Paediatrics CMH Multan,
Dr. Muhammad Faisal Shafiq
MBBS, FCPS (Pediatric medicine), FCPS (Neonatal Medicine), Assistant Professor & HOD Pediatric Department, CMH Multan
Dr. Iqra Amjad
MBBS, PGR Paediatrics CMH Multan,
Dr. Areej Fatima Khan
MBBS, Women Medical Officer Primary and Secondary Healthcare department ,
Dr. Syeda Ayesha Mazhar
MPhil. Pharmaceutics Student at School of Health Sciences and Social work, Griffith University, Australia
Dr. Muhammad Ali Khan
MBBS, Medical Officer, THQ Hospital Noorpur Thal,