Procalcitonin-guided protocol is not useful to manage antibiotic therapy in febrile neutropenia: a randomized controlled trial

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dc.creatorStella Sala Soareslima
dc.creatorVandack Nobre
dc.creatorRoberta Maia de Castro Romanelli
dc.creatorWanessa Trindade Clemente
dc.creatorHenrique Neves da Silva Bittencourt
dc.creatorAna Catarina Mourão Melo
dc.creatorLuciana Caetano Botelho Salomão
dc.creatorJosé Carlos Serufo
dc.date.accessioned2023-06-30T19:43:43Z
dc.date.accessioned2025-09-09T01:31:01Z
dc.date.available2023-06-30T19:43:43Z
dc.date.issued2016-04-27
dc.format.mimetypepdf
dc.identifier.doi10.1007/s00277-016-2639-5
dc.identifier.issn09395555
dc.identifier.urihttps://hdl.handle.net/1843/55648
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofAnnals of Hematology
dc.rightsAcesso Restrito
dc.subjectPró-Calcitonina
dc.subjectNeutropenia Febril
dc.subjectAntibacterianos
dc.subjectInfecção Hospitalar
dc.subject.otherProcalcitonin
dc.subject.otherFebrile neutropenia
dc.subject.otherAntibiotic
dc.subject.otherInfection
dc.titleProcalcitonin-guided protocol is not useful to manage antibiotic therapy in febrile neutropenia: a randomized controlled trial
dc.typeArtigo de periódico
local.citation.epage1176
local.citation.issue7
local.citation.spage1169
local.citation.volume95
local.description.resumoFebrile 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.
local.identifier.orcidhttps://orcid.org/0000-0003-0848-3740
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIA
local.publisher.departmentMED - DEPARTAMENTO DE PROPEDÊUTICA COMPLEMENTAR
local.publisher.initialsUFMG
local.url.externahttps://link.springer.com/article/10.1007/s00277-016-2639-5

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