Procalcitonin Guided Antibiotic Therapy
Intra-Abdominal Infections
About this trial
This is an interventional other trial for Intra-Abdominal Infections
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 years old
- Ability to give consent in English or Spanish
- Imaging proven intra-abdominal infection (CT, US, and/or MRI)
Exclusion Criteria:
- Unable to give informed consent
- Patients enrolled in another trial
- Those having surgery for source control
- Patients with anastomotic leak
- Unable or unwilling to return or be contacted for clinical follow-up visits
- Currently incarcerated in a detention facility or in police custody
- Conditions with altered immune response or at risk for bacterial seeding
- Immunodeficiency (e.g., absolute neutrophil count <500/mm3, chronic immunosuppressive drugs, active chemotherapy or plans for chemotherapy in the following 30 days, or known AIDS [CD4 count <200 or AIDS-defining illness within the last year] assessed by patient history)
- Uncompensated liver failure
- Taking medication to treat active inflammatory bowel disease
- Malignancy, not in remission (ongoing chemotherapy patients excluded)
- Pregnant or expectation of becoming pregnant in the 30 days following baseline/screening
- Expected concurrent hemodialysis, peritoneal dialysis, or treatments using indwelling venous catheters
- Recent (within 90 days) placement of surgical implant (e.g., pacemaker, joint prosthesis, mechanical valve)
- Indwelling Left Ventricular Assist Device
- Patients with another infection (e.g., pneumonia, urinary tract infection) that requires treatment with another antibiotic
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Other
Experimental
Control Arm
Treatment Arm
Participants randomized to the control arm will be managed with the current standard of care including daily white blood cell count and vital sign documentation. The control group will also have daily procalcitonin levels drawn but the results will not be used to make decisions regarding antibiotic duration. Antibiotics will be given orally or intravenously at the discretion of the treating physician and will be given for a 10-day course, the current standard of care.
These participants will be managed with procalcitonin-guided antibiotic therapy. An index procalcitonin will be drawn within 24 hours of admission followed by daily procalcitonin levels. Per standard of care, patients will have daily white blood cell counts drawn and regular vital sign documentation. Antibiotics will be given orally or intravenously at the discretion of the treating physician. Antibiotics in this arm will be stopped once the procalcitonin value drops to ≤80% of its index value or to <0.5 ng/ml. Extension of antibiotics for more than 24 hours past this time will be documented.