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  • Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis

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Commentary
Maternal and child health
Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis
  1. Meret Merker1,2,
  2. Rebekka Bolliger1,2,
  3. Philipp Schuetz1,2
  1. 1 University Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
  2. 2 Department of Clinical Research, University of Basel, Basel, Switzerland
  1. Correspondence to Dr Philipp Schuetz, University Department of Internal Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland; schuetzph{at}gmail.com

https://doi.org/10.1136/bmjebm-2017-110838

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    Commentary on: Stocker M, van Herk W, El Helou S, et al. Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns). Lancet 2017;390:871–81.

    Context

    The diagnostic approach of sepsis in neonates is challenging with lack of sensitive and specific microbiological tests leading ultimately to antibiotic overuse in this population. Host-derived blood markers of infection are promising tools to better guide antibiotic management. In adults, use of procalcitonin (PCT) has shown to reduce antibiotic usage with positive effects on clinical outcome.1 The study by Stocker et al assessed whether the concept of PCT-guided antibiotic management would also work in neonates.2

    Methods

    This is a multicentre, randomised controlled trial that prospectively included neonates with suspected early-onset sepsis in 18 different Hospitals in the Netherlands, Switzerland, Canada and Czech Republic. Probability of sepsis was assessed by scoring system based on risk factors, clinical symptoms and conventional laboratory tests. Neonates were …

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    Footnotes

    • Contributors MM drafted the comment, RB and PS commented on the final document.

    • Competing interests The institution of PS received research support from Thermofisher and BioMerieux.

    • Provenance and peer review Commissioned; internally peer reviewed.