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Type:	Artigo de Periódico
Title:	Procalcitonin-guided protocol is not useful to manage antibiotic therapy in febrile neutropenia: a randomized controlled trial
Authors:	Stella Sala Soareslima Vandack Nobre Roberta Maia de Castro Romanelli Wanessa Trindade Clemente Henrique Neves da Silva Bittencourt Ana Catarina Mourão Melo Luciana Caetano Botelho Salomão José Carlos Serufo
Abstract:	Febrile neutropenia (FN) requires immediate use of antibiotics (ATB), and procalcitonin (PCT) is proven to be useful in guiding antibiotic therapy in different settings. This study investigated the use of PCT as a guide for the duration of ATB in FN. A randomized controlled trial was carried out from January–December 2010. A total of 62 hematological adult patients with FN were randomized, in 1:1 ratio, into two groups: (1) PCT group: length of ATB guided by institu tional protocol plus PCT dynamics, and (2) control group: duration of ATB in accordance with institutional protocol. There was no difference between groups regarding the use of ATB for the first episode of fever (HR 1.14, 95 % CI 0.66–1.95, p = 0.641), with equivalent median duration of ATB therapy (PCT group 9.0 days and control group 8.0 days, p = 0.67), and median number of days without ATB (0 days, IQR 0–2 days for both groups, p = 0.96). We observed no difference in clinical cure rate (p = 0.68), infection relapse (p = 1.0), superinfection (p = 0.85), length of hospitalization (p = 0.64), and mortality at 28 days (p= 0.39) and at 90 days (p = 0.72). Considering the cut-off of 0.5 ng/ml, PCT was cor related with bacteremia (sensitivity of 51.9 % and specificity of 76.5 %). In this randomized controlled trial, adding a PCT guided protocol to the standard recommendations did not reduce the use of antibiotics in febrile neutropenia, although no apparent harm was caused. PCT proved to be a marker of bacteremia in this setting.
Subject:	Pró-Calcitonina Neutropenia Febril Antibacterianos Infecção Hospitalar
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	MED - DEPARTAMENTO DE PEDIATRIA MED - DEPARTAMENTO DE PROPEDÊUTICA COMPLEMENTAR
Rights:	Acesso Restrito
metadata.dc.identifier.doi:	10.1007/s00277-016-2639-5
URI:	http://hdl.handle.net/1843/55648
Issue Date:	27-Apr-2016
metadata.dc.url.externa:	https://link.springer.com/article/10.1007/s00277-016-2639-5
metadata.dc.relation.ispartof:	Annals of Hematology
Appears in Collections:	Artigo de Periódico

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