Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 117] Role of Procalcitonin in Guiding Antimicrobial Usage in Acute Pancreatitis – a Randomized Clinical Trial
Raj Kumar NAGARAJAN 1, Chakravarthy P 1, Apurba SASTRY 1
1 General Surgery, Jawaharlal Institute of Post Graduate Medical Education And Research(JIPMER),Puducherry, INDIA, 2 Microbiology, Jawaharlal Institute of Post Graduate Medical Education And Research(JIPMER),Puducherry, INDIA
Background : Prophylactic antibiotics has no role in acute pancreatitis(AP) and it has been observed that 23.5% of cases received it without evidence of infection. Procalcitonin (PCT) based algorithm can differentiate bacterial sepsis from systemic inflammatory response. Hence Procalcitonin-based algorithm guided antibiotic usage will lead to reduced antibiotic usage in patients with acute pancreatitis without any adverse outcomes.
Methods : A single-center, prospective, single blinded RCT carried out in the Department of Surgery. A total of 152 patients with AP were randomly assigned to nPCT group (n=73) and PCT group (n=71). Patients in PCT group were treated with antibiotics based on PCT values (To start or continue antibiotics when the PCT value was >1ng/ml and discontinue or avoid antibiotics if PCT is <1ng/ml). Otherwise, both groups received standard of care. Duration of antibiotics, Length of hospital stay, Mortality and readmission rates were measured and analyzed.
Results : The proportion of patients receiving antibiotics in nPCT group was 45.2% (33 patients) and in PCT group it was 36.6% (26 patients). Although there was 9% reduction in patients receiving antibiotics in the PCT group, it was not statistical significant (p=0.295). There was no significant difference between groups induration of antibiotic usage, length of hospital stay, readmission, and mortality rates. Subgroup analysis, based on severity of pancreatitis was not statistically significant.
Conclusions : Procalcitonin based antibiotic therapy reduced antibiotic usage by 9% in our study population. Further studies are needed to test the role of procalcitonin in guiding antibiotic usage in Indian population.
Methods : A single-center, prospective, single blinded RCT carried out in the Department of Surgery. A total of 152 patients with AP were randomly assigned to nPCT group (n=73) and PCT group (n=71). Patients in PCT group were treated with antibiotics based on PCT values (To start or continue antibiotics when the PCT value was >1ng/ml and discontinue or avoid antibiotics if PCT is <1ng/ml). Otherwise, both groups received standard of care. Duration of antibiotics, Length of hospital stay, Mortality and readmission rates were measured and analyzed.
Results : The proportion of patients receiving antibiotics in nPCT group was 45.2% (33 patients) and in PCT group it was 36.6% (26 patients). Although there was 9% reduction in patients receiving antibiotics in the PCT group, it was not statistical significant (p=0.295). There was no significant difference between groups induration of antibiotic usage, length of hospital stay, readmission, and mortality rates. Subgroup analysis, based on severity of pancreatitis was not statistically significant.
Conclusions : Procalcitonin based antibiotic therapy reduced antibiotic usage by 9% in our study population. Further studies are needed to test the role of procalcitonin in guiding antibiotic usage in Indian population.
SESSION
E-poster
E-Session 03/21 ALL DAY