Procalcitonin to guide duration of antibiotic therapy in intensive care patients some research questions 英文参考文献.docVIP

Available online /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 Critical Care 2009, 13:414 (doi:10.1186/cc7958) This article is online at /content/13/4/414 ? 2009 BioMed Central Ltd See related research by Hochreiter et al., /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]. 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 out- come for those patients diagnosed with pneumonia and those diagnosed with peritonitis in either the control group or the procalcitonin-guided antibiotic therapy group? 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. 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 Müller have proposed further study of alternative novel biomarkers [3,4]. Early diagnosis of sepsis linked to timely but limited use of antibiotics remains paramount, whichever biomarkers make it possible to save more patients’ lives in intensive