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Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy In Septic Patients: A Multicenter, Prospective Cohort Trial.

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收录情况： ◇ SCIE

作者：
Hongli Xiao[1] * ; Guoxing Wang[1] * ; Yan Wang[1] ; Zhimin Tan[1] ; Xuelian Sun[1] ; Jie Zhou[1] ; Meili Duan[2] ; Deyuan Zhi[2] ; Ziren Tang[3] ; Chenchen Hang[3] ; Guoqiang Zhang[4] ; Yan Li[4] ; Caijun Wu[5] ; Fengjie Li[6] ; Haiyan Zhang[7] ; Jing Wang[8] ; Yun Zhang[9] ; Xinchao Zhang[10] ; Wei Guo[11] ; Wenjie Qi[12] ; Miaorong Xie[1,*1] ; Chunsheng Li[1,*1] ;
机构： [1]EICU of Department of Emergency Medicine, Beijing Friendship Hospital, Capital MedicalUniversity, 95 Yongan Road, Beijing 100050, China [2]Department of critical care medicine,Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China [3]EICU ofDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical University,8 Workers' Stadium South Road, Beijing 100020, China [4]EICU of Department ofEmergency Medicine, China-Japan Friendship Hospital, Peking Union Medical College,Yinhua East Road, Chaoyang District, Beijing 100029, China [5]EICU of Department ofEmergency Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, 5Haiyangzang, Dongcheng District, Beijing 100700, China [6]EICU of Department ofEmergency Medicine, Beijing Luhe Hospital, Capital Medical University, 82 Xinhua SouthRoad, Tongzhou District, Beijing 101100, China [7]EICU of Department of EmergencyMedicine, The Hospital of Shunyi District Beijing, China Medical University, 3 GuangmingSouth Street, Shunyi District, Beijing 101300, China [8]EICU of Department of EmergencyMedicine, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, XichengDistrict, Beijing 100053, China [9]EICU of Department of Emergency Medicine, BeijingTongren Hospital, Capital Medical University, 8 Chongwenmen inner street, DongchengDistrict, Beijing 100005, China [10]EICU of Department of Emergency Medicine, BeijingHospital, National Center of Gerontology, Peking Union Medical College, 1 Dahua Road,Dongdan, Dongcheng District, Beijing 100730, China [11]EICU of Department of EmergencyMedicine, Beijing Tiantan Hospital, Capital Medical University, 119 West Road, SouthFourth Ring Road, Fengtai District, Beijing 100070, China [12]Department of InfectiousDisease, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
出处：
DOI： 10.1097/SHK.0000000000001870
ISSN：

关键词： Presepsin sepsis antibiotics

摘要：
Long-term use of antibiotics for septic patients leads to bacterial resistance, increased mortality, and hospital stay. In this study, we investigated an emerging biomarker presepsin-guided strategy, which can be used to evaluate the shortening of antibiotic treatment in patients with sepsis without risking a worse outcome.In this multicenter prospective cohort trial, patients were assigned to the presepsin or control groups. In the presepsin group, antibiotics were ceased based on predefined cut-off ranges of presepsin concentrations. The control group stopped antibiotics according to international guidelines. The primary endpoints were the number of days without antibiotics within 28 days and mortality at 28 and 90 days. Secondary endpoints were the percentage of patients with a recurrent infection, length of stay in ICU and hospital, hospitalization costs, days of first episode of antibiotic treatment, percentage of antibiotic administration and multidrug-resistant bacteria, and SOFA score.Overall, 656 out of an initial 708 patients were eligible and assigned to the presepsin group (n = 327) or the control group (n = 329). Patients in the presepsin group had significantly more days without antibiotics than those in the control group (14.54 days [SD 9.01] vs. 11.01 days [SD 7.73]; P < 0.001). Mortality in the presepsin group showed no difference to that in the control group at days 28 (17.7% vs. 18.2%; P = 0.868) and 90 (19.9% vs. 19.5%; P = 0.891). Patients in the presepsin group had a significantly shorter mean length of stay in the hospital and lower hospitalization costs than control subjects. There were no differences in the rate of recurrent infection and multidrug-resistant bacteria and the SOFA score tendency between the two groups.Presepsin guidance has potential to shorten the duration of antibiotic treatment in patients with sepsis without risking worse outcomes of death, recurrent infection, and aggravation of organ failure.ChiCTR, ChiCTR1900024391. Registered 9 July 2019-Retrospectively registered, http://www.chictr.org.cn.Copyright © 2021 by the Shock Society.

基金：
Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support “Yangfan” Project [ZYLX201802]; the Beijing Municipal Administration of Hospitals' Youth Program [QML20170105] and the National Natural Science Foundation of China [81374004, 81773931].
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2021]版：
大类 | 2 区 医学
小类 | 2 区 外科 3 区 危重病医学 3 区 血液学 3 区 外周血管病
最新[2025]版：
大类 | 3 区 医学
小类 | 3 区 血液学 3 区 外周血管病 3 区 外科 4 区 危重病医学
JCR分区：
出版当年[2020]版：
Q2 HEMATOLOGY Q2 PERIPHERAL VASCULAR DISEASE Q2 CRITICAL CARE MEDICINE Q2 SURGERY
最新[2023]版：
Q1 SURGERY Q2 CRITICAL CARE MEDICINE Q2 HEMATOLOGY Q2 PERIPHERAL VASCULAR DISEASE

影响因子： 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

第一作者：
第一作者机构： [1]EICU of Department of Emergency Medicine, Beijing Friendship Hospital, Capital MedicalUniversity, 95 Yongan Road, Beijing 100050, China
共同第一作者：
通讯作者：
通讯机构： [1]EICU of Department of Emergency Medicine, Beijing Friendship Hospital, Capital MedicalUniversity, 95 Yongan Road, Beijing 100050, China [*1]EICU of Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing 100050, China
推荐引用方式(GB/T 7714)：
Hongli Xiao,Guoxing Wang,Yan Wang,et al.Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy In Septic Patients: A Multicenter, Prospective Cohort Trial.[J].SHOCK.2022,57(1):63-71.doi:10.1097/SHK.0000000000001870.
APA：
Hongli Xiao,Guoxing Wang,Yan Wang,Zhimin Tan,Xuelian Sun...&Chunsheng Li.(2022).Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy In Septic Patients: A Multicenter, Prospective Cohort Trial..SHOCK,57,(1)
MLA：
Hongli Xiao,et al."Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy In Septic Patients: A Multicenter, Prospective Cohort Trial.".SHOCK 57..1(2022):63-71

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