PCT Monitoring Can Aid in Determining Duration of Antibiotic Therapy in Sepsis Patients

Dark P, Hossain A, McAuley DF, et al. Biomarker-Guided Antibiotic Duration for Hospitalized Patients with Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial. JAMA. 2024; in press.

Procalcitonin (PCT) and C-reactive protein (CRP) assays are used to guide decisions regarding duration of antibiotic usage in hospitalized patients with sepsis. This randomized prospective trial sought to determine whether use of these protocols safely reduced the duration of antibiotic therapy.

Safety of the protocols was assessed by comparing mortality risk in the PCT and CRP groups to patients receiving standard care. Standard care was defined as no reporting of CRP or PCT data but provision of daily advice on sepsis treatment.

The study included 2,760 patients cared for in 41 intensive care units in Great Britain. The primary outcomes of interest were the total duration of antibiotic therapy and 28-day mortality. Hospital and ICU lengths of stay and 90-day mortality were also documented.

The PCT monitoring group had a significant reduction in duration of antibiotic therapy compared to standard care; mortality risk was noninferior in the PCT group compared to standard care.

These data support the effectiveness and safety of PCT monitoring to determine the duration of antibiotic therapy in patients with sepsis.