Publication: Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: Adaptation based on an expert consensus meeting
Issued Date
2020-01-01
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ISSN
14374331
14346621
14346621
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2-s2.0-85078219846
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Chemistry and Laboratory Medicine. (2020)
Suggested Citation
Chien Chang Lee, Andrea Lay Hoon Kwa, Anucha Apisarnthanarak, Jia Yih Feng, Eric Howard Gluck, Akihiro Ito, Anis Karuniawati, Petrick Periyasamy, Busadee Pratumvinit, Jeetendra Sharma, Rontgene Solante, Subramanian Swaminathan, Niraj Tyagi, Dien Minh Vu, Kapil Zirpe, Philipp Schuetz Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: Adaptation based on an expert consensus meeting. Clinical Chemistry and Laboratory Medicine. (2020). doi:10.1515/cclm-2019-1122 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/53615
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Title
Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: Adaptation based on an expert consensus meeting
Other Contributor(s)
Duke-NUS Medical School Singapore
Artemis Health Sciences
National Taiwan University Hospital
San Lazaro Hospital
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Thammasat University Hospital
Sir Ganga Ram Hospital
Universitat Basel
Kantonsspital Aarau
Singapore General Hospital
Swedish Covenant Hospital
Veterans General Hospital-Taipei
Faculty of Medicine, Siriraj Hospital, Mahidol University
Kurashiki Central Hospital
Universiti Kebangsaan Malaysia
B.G.S Gleneagles Global Hospital
National Hospital of Tropical Diseases
Grant Medical Foundation
Artemis Health Sciences
National Taiwan University Hospital
San Lazaro Hospital
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Thammasat University Hospital
Sir Ganga Ram Hospital
Universitat Basel
Kantonsspital Aarau
Singapore General Hospital
Swedish Covenant Hospital
Veterans General Hospital-Taipei
Faculty of Medicine, Siriraj Hospital, Mahidol University
Kurashiki Central Hospital
Universiti Kebangsaan Malaysia
B.G.S Gleneagles Global Hospital
National Hospital of Tropical Diseases
Grant Medical Foundation
Abstract
© 2020 ©2020 Philipp Schuetz et al., published by De Gruyter, Berlin/Boston. Recently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care. Practical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific. Using a Delphi process, the group reached consensus on two PCT algorithms for the critically ill and the non-critically ill patient populations. The group agreed that the existing evidence for PCT-guided antibiotic stewardship in patients with acute respiratory infections and sepsis is generally valid also for Asia-Pacific countries, in regard to proposed PCT cut-offs, emphasis on diagnosis, prognosis and antibiotic stewardship, overruling criteria and inevitable adaptations to clinical settings. However, the group noted an insufficient database on patients with tropical diseases currently limiting the clinical utility in these patients. Also, due to lower resource availabilities, biomarker levels may be measured less frequently and only when changes in treatment are highly likely. Use of PCT to guide antibiotic stewardship in conjunction with continuous education and regular feedback to all stakeholders has high potential to improve the utilization of antibiotic treatment also in Asia-Pacific countries. However, there is need for adaptations of existing algorithms due to differences in types of infections and routine clinical care. Further research is needed to understand the optimal use of PCT in patients with tropical diseases.