Procalcitonin-guided antibiotic therapy in aspiration pneumonia and an assessment of the continuation of oral intake

Abstract Background Procalcitonin-guided antibiotic therapy for community-acquired pneumonia is effective and safe. However, the usefulness of procalcitonin for aspiration pneumonia and its nutrition-related outcomes are unknown. Methods We conducted a noninferiority randomized controlled study in p...

Full description

Saved in:
Bibliographic Details
Published in:Respiratory investigation 2014-03, Vol.52 (2), p.107-113
Main Authors: Ogasawara, Takashi, Umezawa, Hiroki, Naito, Yusuke, Takeuchi, Takao, Kato, Shinpei, Yano, Toshiaki, Kasamatsu, Norio, Hashizume, Ikko
Format: Article
Language:English
Subjects:
Administration, Oral
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage
Aspiration pneumonia
Biomarkers - blood
Body mass index
Calcitonin - blood
Calcitonin Gene-Related Peptide
Endpoint Determination
Enteral Nutrition
Female
Humans
Internal Medicine
Male
Multivariate Analysis
Oral intake
Pneumonia, Aspiration - diagnosis
Pneumonia, Aspiration - drug therapy
Procalcitonin
Prospective Studies
Protein Precursors - blood
Pulmonary/Respiratory
Retrospective Studies
Time Factors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Procalcitonin-guided antibiotic therapy for community-acquired pneumonia is effective and safe. However, the usefulness of procalcitonin for aspiration pneumonia and its nutrition-related outcomes are unknown. Methods We conducted a noninferiority randomized controlled study in patients with aspiration pneumonia who were admitted to our hospital between September 2010 and January 2012. We randomly assigned 105 patients to groups with different durations of antibiotic therapy based on the procalcitonin levels upon admission (procalcitonin group) or according to the standard guidelines (control group). The primary endpoints were relapse of aspiration pneumonia and death within 30 days, with a predefined noninferiority boundary of 10%. Secondary endpoints included duration of antibiotic exposure. Furthermore, we conducted a retrospective analysis of the prognostic factors that determined continuation of oral nutritional intake, relapse of pneumonia, and in-hospital death. Results The rate of relapse and death within 30 days were similar in the procalcitonin and control groups (25% versus 37.5%; difference, −12.5%; 95% confidence interval, −30.9% to 5.9%). Procalcitonin-guided antibiotic therapy significantly shortened the median duration of antibiotic exposure (5 versus 8 days; p
ISSN:2212-5345
2212-5353
DOI:10.1016/j.resinv.2013.08.002