Procalcitonin and Endotoxin Sequential Levels to Optimize the Treatment of Bloodstream Infections
| Status: | Completed |
|---|---|
| Conditions: | Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 19 - Any |
| Updated: | 4/22/2018 |
| Start Date: | June 2009 |
| End Date: | June 2016 |
Bloodstream infections (BSI) are a major cause of morbidity and mortality. Community-onset
BSI have an overall attributable mortality of 10-13% while nosocomial BSI mortality ranges
are quite variable from 12-80%. Bloodstream infections are also costly and result in
prolonged hospital stays. Nosocomial BSIs have been shown to increase length of stay by 5-25
days and increase costs $23,000 - 40,000 above matched controls. The duration of therapy
necessary to clear blood stream infections is unknown and no study has systematically
addressed this issue. The use of antimicrobials is also not without consequence. These
include financial cost, side-effects, promotion of superinfection (especially Clostridium
difficile-associated diarrhea), and the promotion of microbial resistance. We hypothesize
that a procalcitonin (host biomarker) and endotoxin (microorganism biomarker)-guided
treatment plan could significantly decrease unnecessary exposure to antibiotics in patients
with bloodstream infections.
BSI have an overall attributable mortality of 10-13% while nosocomial BSI mortality ranges
are quite variable from 12-80%. Bloodstream infections are also costly and result in
prolonged hospital stays. Nosocomial BSIs have been shown to increase length of stay by 5-25
days and increase costs $23,000 - 40,000 above matched controls. The duration of therapy
necessary to clear blood stream infections is unknown and no study has systematically
addressed this issue. The use of antimicrobials is also not without consequence. These
include financial cost, side-effects, promotion of superinfection (especially Clostridium
difficile-associated diarrhea), and the promotion of microbial resistance. We hypothesize
that a procalcitonin (host biomarker) and endotoxin (microorganism biomarker)-guided
treatment plan could significantly decrease unnecessary exposure to antibiotics in patients
with bloodstream infections.
Inclusion Criteria:
- Hospitalized, adult patient, at least one positive blood culture reported within 24
hours of enrollment
Exclusion Criteria:
- Previously enrolled in the study; discharged/deceased before first positive culture;
receiving antibiotic for greater than or equal to 48 hours; endocarditis or
osteomyelitis; antithymocyte globulin in the last 12 months; blood cultures positive
for coagulase-negative staphylococcus only.
We found this trial at
1
site
Nebraska Medical Center Formed in 1997 by combining the operations of University Hospital, Bishop Clarkson...
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