Volume 21 Issue 2
Feb.  2023
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(2): 186-189
LIU Yao, WU Jin-huan, FAN Ming-xing, CHEN Jun, ZHAO Shao-dong, MIAO Hong-jun. Clinical study of dynamic monitoring of serum procalcitonin for anti-infection treatment in children with severe community acquired pneumonia[J]. Chinese Journal of General Practice, 2023, 21(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.002841
Citation: LIU Yao, WU Jin-huan, FAN Ming-xing, CHEN Jun, ZHAO Shao-dong, MIAO Hong-jun. Clinical study of dynamic monitoring of serum procalcitonin for anti-infection treatment in children with severe community acquired pneumonia[J]. Chinese Journal of General Practice, 2023, 21(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.002841
shu

Clinical study of dynamic monitoring of serum procalcitonin for anti-infection treatment in children with severe community acquired pneumonia

doi: 10.16766/j.cnki.issn.1674-4152.002841
  • 1.

    Department of Pharmacy, Children ' s Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, China

Funds:

 BK20170147

 A202218

  • Received Date: 2022-11-21
    Available Online: 2023-04-20
    Abstract
  •   Objective  To explore the guiding significance and application value of dynamic monitoring of serum procalcitonin for anti-infection therapy in children with severe community acquired pneumonia.  Methods  A total of 150 children with severe community acquired pneumonia treated in Nanjing Children ' s Hospital from January 2019 to June 2022 were enrolled. They were assigned into observation group (65 cases) and control group (85 cases) according to whether dynamic procalcitonin monitoring was performed. The control group was treated with conventional antibacterial drugs, while the observation group was adjusted with the results of PCT dynamic monitoring. The use rate of antibiotics, the course of use, the cumulative consumption of antibiotics, the choice of drugs, the duration of fever, the time of ICU stay, and the outcome of discharge were compared between the two groups.  Results  The cumulative consumption of antibacterial drugs per capita in the control group was 3.50 (1.92, 6.20), while it was significantly lower than that in the observation group [2.13 (1.25, 4.95), P < 0.05]. The duration of antimicrobial treatment in the observation group was about 1 day shorter than that in the control group [7.0 (5.0, 10.0) days vs. 8.0 (5.0, 11.0) days, P < 0.05]. The total cost of antimicrobial drugs in the control group was 1 659.0 (1 036.3, 3 263.2) yuan, which was significantly higher than that in the observation group [762.2 (243.3, 1 423.8) yuan, P < 0.01]. The use rate of special grade antibiotics in the observation group was lower than that in the control group [27.3% (18/66) vs. 51.8% (44/85), P < 0.01]. There was no difference in the duration of fever, the time of ICU stay, the outcome of discharge between the two groups (P>0.05).  Conclusion  Dynamic monitoring of serum PCT is helpful to the rational use of antibiotics in children with severe community-acquired pneumonia, especially for the use, degradation and discontinuation of special grade antibiotics.

     

    • FullText(HTML)
  • loading
    • References(20)
  • [1]
    中华人民共和国国家健康委员会, 国家中医药局. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 中华临床感染病杂志, 2019, 12(1): 6-13. doi: 10.3760/cma.j.issn.1674-2397.2019.01.002

    National Health Commission of the People's Republic of China, State Administration of Traditional Chinese Medicine. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 中华临床感染病杂志, 2019, 12(1): 6-13. doi: 10.3760/cma.j.issn.1674-2397.2019.01.002
    [2]
    HAMADA B, HUANG D T. Procalcitonin: where are we now?[J]. Crit Care Clin, 2020, 36(1): 23-40. doi: 10.1016/j.ccc.2019.08.003
    [3]
    中华医学会儿科学分会医院感染管理与控制专委会. 儿童感染性疾病降钙素原应用专家共识[J]. 实用休克杂志(中英文), 2019, 3(1): 45-51. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYW201901011.htm

    Special Committee of Nosocomial Infection Management and Control of Pediatrics Branch of Chinese Medical Association. 儿童感染性疾病降钙素原应用专家共识[J]. 实用休克杂志(中英文), 2019, 3(1): 45-51. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYW201901011.htm
    [4]
    COVINGTON E W, ROBERTS M Z, DONG J. Procalcitonin monitoring as a guide for antimicrobial therapy: a review of current literature[J]. Pharmacotherapy, 2018, 38(5): 569-581. doi: 10.1002/phar.2112
    [5]
    LANGFORD B J, BERIAULT D, SCHWARTZ K L, et al. A real-world assessment of procalcitonin combined with antimicrobial stewardship in a community ICU[J]. J Crit Care, 2020, 57: 130-133. doi: 10.1016/j.jcrc.2020.02.009
    [6]
    XIAO H, JIA H Y, YUAN X W, et al. The value of dynamic monitoring of procalcitonin in the early identification of pathogens and prognosis of bloodstream infections in the ICU[J]. Ann Palliat Med, 2021, 10(12): 12208-12217. doi: 10.21037/apm-21-3232
    [7]
    罗双红, 舒敏, 温杨, 等. 中国0至5岁儿童病因不明急性发热诊断和处理若干问题循证指南(标准版)[J]. 中国循证儿科杂志, 2016, 11(2): 81-96. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK201602001.htm

    LUO S H, SHU M, WEN Y, et al. Evidence-based guidelines for the diagnosis and management of acute fever of unknown etiology in children aged 0 to 5 years in China (standard Edition)[J]. Chinese Journal of Evidence-Based Pediatrics, 2016, 11(2): 81-96. https://www.cnki.com.cn/Article/CJFDTOTAL-XZEK201602001.htm
    [8]
    GOLDSTEIN B, GIROIR B, RANDOLPH A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics[J]. Pediatr Crit Care Med, 2005, 6(1): 2-8. doi: 10.1097/01.PCC.0000149131.72248.E6
    [9]
    SCHUETZ P, BEISHUIZEN A, BROYLES M, et al. Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use[J]. Clin Chem Lab Med, 2019, 57(9): 1308-1318. doi: 10.1515/cclm-2018-1181
    [10]
    王俏. 降钙素原在重症肺炎中的临床应用[J]. 中国现代药物应用, 2022, 16(5): 26-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY202205002.htm

    WANG Q. Clinical application of procalcitonin in the treatment of severe pneumonia[J]. Chinese Journal of Modern Drug Application, 2022, 16(5): 26-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY202205002.htm
    [11]
    赵晓玲, 袁泽芹. 降钙素原在评估和预测儿童社区获得性肺炎严重程度和指导抗菌药物治疗的应用进展[J]. 检验医学与临床, 2020, 17(16): 2415-2418. doi: 10.3969/j.issn.1672-9455.2020.16.050

    ZHAO X L, YUAN Z Q. Application of procalcitonin in the evaluation and prediction of severity of community-acquired pneumonia in children and guidance of antimicrobial therapy[J]. Laboratory Medicine and Clinic, 2020, 17(16): 2415-2418. doi: 10.3969/j.issn.1672-9455.2020.16.050
    [12]
    DUDOGNON D, LEVY C, CHALUMEAU M, et al. Diagnostic accuracy of routinely available biomarkers to predict bacteremia in children with community-acquired pneumonia: a secondary analysis of the GPIP/ACTIV pneumonia study in France, 2009-2018[J]. Front Pediatr, 2021, 9: 684628. DOI: 10.3389/fped.2021.684628.
    [13]
    FLORIN T A, WILLIAMS D J. PRO: procalcitonin has clinical utility in children with community-acquired pneumonia[J]. JAC Antimicrob Resist, 2021, 3(4): dlab158. DOI: 10.1093/jacamr/dlab158.
    [14]
    陈静, 刘克亮, 龙颖婷. 血清降钙素原在儿童细菌性上呼吸道感染诊断中的应用价值[J]. 医疗装备, 2021, 34(20): 28-29. doi: 10.3969/j.issn.1002-2376.2021.20.013

    CHEN J, LIU K L, LONG Y T. Diagnostic value of serum procalcitonin in children with bacterial upper respiratory tract infection[J]. Medical Equipment, 2021, 34(20): 28-29. doi: 10.3969/j.issn.1002-2376.2021.20.013
    [15]
    KYRIAZOPOULOU E, LIASKOU-ANTONIOU L, ADAMIS G, et al. Procalcitonin to reduce long-term infection-associated adverse events in sepsis. A randomized trial[J]. Am J Respir Crit Care Med, 2021, 203(2): 202-210. doi: 10.1164/rccm.202004-1201OC
    [16]
    JEON K, SUH J K, JANG E J, et al. Procalcitonin-guided treatment on duration of antibiotic therapy and cost in septic patients (PRODA): a multi-center randomized controlled trial[J]. J Korean Med Sci, 2019, 34(14): e110. DOI: 10.3346/jkms.2019.34.e110.
    [17]
    WILLIAMS E J, MAIR L, DE SILVA T I, et al. Evaluation of procalcitonin as a contribution to antimicrobial stewardship in SARS-CoV-2 infection: a retrospective cohort study[J]. J Hosp Infect, 2021, 110: 103-107. doi: 10.1016/j.jhin.2021.01.006
    [18]
    RATAGERI V H, PANIGATTI P, MUKHERJEE A, et al. Role of procalcitonin in diagnosis of community acquired pneumonia in children[J]. BMC Pediatr, 2022, 22(1): 217. doi: 10.1186/s12887-022-03286-2
    [19]
    BASHIR A, KHAN R, THOMPSON S, et al. A retrospective observational study of biomarker levels and severity assessment in pediatric community-acquired pneumonia[J]. Medicine (Baltimore), 2022, 101(32): e30010. DOI: 10.1097/MD.0000000000030010.
    [20]
    降钙素原在成人下呼吸道感染性疾病分级管理中的应用专家共识组. 降钙素原在成人下呼吸道感染性疾病分级管理中的应用专家共识[J]. 中华急诊医学杂志, 2021, 30(4): 393-401. doi: 10.3760/cma.j.issn.1671-0282.2021.04.004

    Expert consensus group on the use of procalcitonin in the graded management of lower respiratory tract infectious diseases in adults. Expert consensus on the application of procalcitonin in grading management of adult lower respiratory tract infectious diseases[J]. Chinese Journal of Emergency Medicine, 2021, 30(4): 393-401. doi: 10.3760/cma.j.issn.1671-0282.2021.04.004
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (257) PDF downloads(14) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return