Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
NCT07211620

KInetics of Procalcitonin to Reduce Unnecessary aNtibiotic Use - Comparing Procalcitonin Kinetics-guided and Absolute Procalcitonin Value-guided Antibiotic Initiation in Reducing Unnecessary Antibiotic Use in Critically Ill Patients

Led by Semmelweis University · Updated on 2026-01-09

250

Participants Needed

2

Research Sites

107 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

The study aims to compare the efficacy and safety of an absolute procalcitonin (PCT) value-guided antibiotic initiation protocol and a protocol using the kinetics of PCT (the difference between the actual and the previous day value) in hemodynamically stable critically ill patients with suspected new-onset infection on admission or during ICU stay. The main question it aims to answer: * Can the investigators decrease the number of unnecessary AB therapies using the kinetics of PCT insted of using absolute PCT values? * Is it safe to use PCT kinetics together with the clinical picture to guide AB initiation? AB therapy will be initiated according to predefined PCT protocols (Kinetics and Absolute Group). After 72 hours of treatment, an independent multidisciplinary team (infectologist, microbiologist and intensivist) will decide about the necessity of the treatment with all the relevant results in hand.

CONDITIONS

Official Title

KInetics of Procalcitonin to Reduce Unnecessary aNtibiotic Use - Comparing Procalcitonin Kinetics-guided and Absolute Procalcitonin Value-guided Antibiotic Initiation in Reducing Unnecessary Antibiotic Use in Critically Ill Patients

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Adult patients aged 18 years or older
  • Non-surgical, surgical, or trauma patients
  • Suspected new-onset infection at admission or during ICU stay
  • Known or highly suspected infection source with source control implemented if needed
  • Two procalcitonin values available: one on the day of suspected infection and one 24 ± 4 hours earlier
  • Microbiology sampling performed according to presumed infection sources
  • Written informed consent provided by patient or legal guardian
Not Eligible

You will not qualify if you...

  • Septic shock requiring vasopressors and with serum lactate >2 mmol/L after fluids
  • Infections needing long-term antibiotic treatment (e.g., infective endocarditis, osteoarticular infections, chronic prostatitis, tuberculosis)
  • Infections related to surgical interventions without guaranteed source control (e.g., fecal peritonitis, pancreatic necrosectomy, necrotizing fasciitis)
  • Indisputable infections such as hepatic abscess or empyema
  • Expected ICU stay less than 24 hours or APACHE II score over 30
  • Admission after cardiopulmonary resuscitation
  • Severe immunosuppression other than steroid use
  • Stem-cell or solid organ transplant recipients
  • HIV infection with CD4 count below 200 cells/mm3
  • Neutropenia with fewer than 500 neutrophils/mm3
  • Antibiotic use within 72 hours before inclusion
  • Pregnancy or breastfeeding; women of childbearing age must have a negative pregnancy test before inclusion

AI-Screening

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Trial Site Locations

Total: 2 locations

1

Saint Margaret's Hospital

Budapest, Hungary, 1032

Not Yet Recruiting

2

Semmelweis University, Department of Intensive Therapy

Budapest, Hungary, 1082

Actively Recruiting

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Research Team

M

Márton Papp

CONTACT

Z

Zsolt Molnár

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

DOUBLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

DIAGNOSTIC

Number of Arms

2

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