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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2022, Number 4

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An Med Asoc Med Hosp ABC 2022; 67 (4)

Association between serum procalcitonin levels and the need for antimicrobial therapy in adults with acute diarrhea

Salado-Burbano JC, Aguilar-Soto M, Hoyo-Ulloa IC

Language: Spanish
References: 27
Page: 252-259
PDF size: 316.19 Kb.


ABSTRACT

Introduction: most cases of acute diarrhea have an infectious etiology. In recent years, new diagnostic instruments such as multiplex polymerase chain reaction panels have improved the ability to identify the pathogens responsible for these illnesses. It is currently unknown if serum procalcitonin levels may be useful to guide the need for antimicrobial therapy in this context. Objective: to describe the values of serum procalcitonin in immunocompetent adults with acute diarrhea, categorizing them by their need for specific antimicrobial treatment according to isolated pathogen. Materials and methods: in this observational, retrospective, cross-sectional study, data from patients who had been previously hospitalized due to acute diarrhea were gathered to compare serum procalcitonin levels between cases that would and would not require antimicrobial therapy, according to pathogen identification using a multiplex polymerase chain reaction panel. Secondary objectives included identifying other variables that could predict the need for antimicrobial therapy, as well as describing the frequency and distribution of isolated pathogens. Results: data from 102 previously hospitalized patients with acute diarrhea was gathered (52.9% men, median age 47 years, 56% of cases would require antimicrobial therapy according to isolated pathogen). No difference in initial procalcitonin levels was seen between treatment groups (0.22 vs 0.17 ng/mL, p = 0.3023). The lack of association to require antimicrobial therapy was confirmed with a univariate logistic regression model (OR 1.031, 95% CI: 0.949-1.120). A significant association was observed for vomit (OR 0.264, 95% CI: 0.113-0.616) and blood in feces (OR 14.219, 95% CI: 1.725-117.205). Conclusions: serum procalcitonin levels did not show an association with the need for antimicrobial therapy according to isolated pathogen.


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EVIDENCE LEVEL

III




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