Sevilla VAY, Zaragoza JJ, Cambrón PJP, Ramírez BDK, Portillo PM, Rodríguez GJH

Language: Spanish
References: 15
Page: 8-13
PDF size: 371.61 Kb.

ABSTRACT

Introduction: we evaluated the association between intensive procalcitonin monitoring and clinical outcomes in the ICU. In this retrospective cohort, the monitoring strategy used did not reduce antibiotic duration and was associated with longer stay and mechanical ventilation, without impact on mortality. These findings suggest differences between clinical practice and controlled trials. Objective: to evaluate the association between an intensive procalcitonin monitoring strategy and the duration of antibiotic therapy, as well as other clinical outcomes in the ICU. Material and methods: retrospective cohort study including adults admitted to the ICU with suspected infection between January 2024 and May 2025. Patients were grouped into Intensive Monitoring (≥ 2 procalcitonin measurements) and limited monitoring (0-1). The primary outcome was the duration of first-line antibiotics; secondary outcomes included ICU length of stay, days on mechanical ventilation, hospital mortality, and multidrug-resistant infections. Results: a total of 526 patients were analyzed: 387 in limited monitoring and 139 in intensive monitoring. The intensive group had higher severity at admission (SAPS 3: 25.7 versus 8.0; p < 0.001) and more sepsis (47.5 versus 9.6%; p < 0.001). Intensive monitoring was associated with a lower probability of antibiotic discontinuation (hazard ratio [HR] 0.53), ICU discharge (HR 0.35), and mechanical ventilation liberation (HR 0.26). No significant differences were found in mortality or multidrug-resistant infections. Conclusions: intensive procalcitonin monitoring was paradoxically linked to longer antibiotic therapy and supportive measures, reflecting the greater clinical complexity of patients undergoing intensive monitoring.

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