tailieunhanh - Báo cáo y học: "Procalcitonin to guide duration of antibiotic therapy in intensive care patients: some research questions"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Procalcitonin to guide duration of antibiotic therapy in intensive care patients: some research questions. | Available online http content 13 4 414 Letter Procalcitonin to guide duration of antibiotic therapy in intensive care patients some research questions Robert E Kahn Avian Flu Action 40 St Stephen Road Great Sankey Warrington WA5 2BJ UK Corresponding author Robert E Kahn rs_kahn@ Published 30 July 2009 This article is online at http content 13 4 414 2009 BioMed Central Ltd Critical Care 2009 13 414 doi cc7958 See related research by Hochreiter et al. http content 13 3 R83 The article by Hochreiter and colleagues on the use of procalcitonin to guide duration of antibiotic therapy in intensive care patients is timely and significant but it raises a number of unresolved issues 1 . First it was entirely appropriate that the physician in charge of the surgical intensive care ward had the option to proceed with or to adjust the antibiotic treatment if there were clinical reasons to do so. Whether such adjustments were made either in the control group or in the procalcitonin-guided antibiotic therapy group however is not clear. Second Table 1 in their article indicates a longer number of days in intensive care for those patients in the control group than for those undergoing procalcitonin-guided antibiotic therapy 1 . Since 36 of the patients in each group did not survive however the length of stay in intensive care for both groups may be confounded by death. Finally again in Table 1 1 were there differences in outcome for those patients diagnosed with pneumonia and those diagnosed with peritonitis in either the control group or the procalcitonin-guided antibiotic therapy group Despite more than 10 years of research into the usefulness of procalcitonin therapy Hausfater is right to point out that its exact place in the diagnostic process remains to be defined 2 . Both the articles of McLean and of Christ-Crain and Muller have proposed further study of alternative novel biomarkers 3 4 . Early diagnosis of sepsis linked