JAMA

Biomarker-guided protocol reduces antibiotic use in sepsis patients

December 11, 2024

Study design: The multi-center, randomized ADAPT-Sepsis trial involving 2,760 patients evaluated the effectiveness of procalcitonin (PCT)-guided and C-reactive protein (CRP)-guided protocols in determining the duration of antibiotic therapy for hospitalized patients with suspected sepsis. Participants were randomly assigned to either the PCT-guided group, the CRP-guided group, or the standard care group, with daily PCT or CRP measurements guiding antibiotic discontinuation in the interventions group.

Results: The PCT-guided protocol significantly reduced the duration of antibiotic therapy compared with standard care, without compromising patient safety. Patients in the PCT group had a shorter median duration of antibiotic use and no increase in adverse outcomes such as mortality or infection relapse. No difference was seen in antibiotic duration for standard care vs. daily CRP-guided protocol. The daily CRP-guided protocol was inconclusive compared with standard care for all-cause mortality.

Impact on clinical practice: Implementing a PCT-guided protocol can reduce antibiotic exposure and its associated risks, improving patient outcomes.

Source:

Dark P, et al. (2024, December 9). JAMA. Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39652885/