Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review
Objectives (1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in dia...
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| Veröffentlicht in: | American journal of rhinology & allergy 2019-03, Vol.33 (2), p.103-112 |
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| container_title | American journal of rhinology & allergy |
| container_volume | 33 |
| creator | Dilger, Amanda E. Peters, Anju T. Wunderink, Richard G. Tan, Bruce K. Kern, Robert C. Conley, David B. Welch, Kevin C. Holl, Jane L. Smith, Stephanie Shintani |
| description | Objectives
(1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in diagnosis of bacterial ARS.
Data Sources: PubMed and Embase.
Review Methods: A systematic search in the PubMed and Embase databases was performed to identify studies related to PCT as a biomarker in ARS. After critical appraisal of validity by 2 authors, 6 studies with a total of 313 patients were selected for data extraction and analysis. We identified 2 randomized control trials (RCTs) of PCT-based guidelines for antibiotic management of ARS in outpatient settings and 4 observational studies that compared PCT to other biomarkers in patients with ARS.
Results
The 2 RCTs demonstrated a reduction (41.6% in 1 study and 71% in the other) in antibiotic prescription rate in the PCT-guided group versus the control group with no change in the number of days with impaired activity due to illness (9.0 vs 9.0 days [P = .96]; 8.1 vs 8.2 days [95% confidence interval −0.7 to 0.7]), number of days of work missed, and percentage of patients with persistent symptoms at 28 days. In the observational cohort studies, PCT did not consistently correlate with C-reactive protein, body temperature, and/or white blood cell counts.
Conclusions
The limited existing literature on the role of PCT in diagnosis, management, and prediction of clinical outcomes in ARS suggests that PCT-based guidelines for antibiotic prescription are a safe and effective method of minimizing unnecessary antibiotic use. |
| doi_str_mv | 10.1177/1945892418810293 |
| format | Article |
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(1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in diagnosis of bacterial ARS.
Data Sources: PubMed and Embase.
Review Methods: A systematic search in the PubMed and Embase databases was performed to identify studies related to PCT as a biomarker in ARS. After critical appraisal of validity by 2 authors, 6 studies with a total of 313 patients were selected for data extraction and analysis. We identified 2 randomized control trials (RCTs) of PCT-based guidelines for antibiotic management of ARS in outpatient settings and 4 observational studies that compared PCT to other biomarkers in patients with ARS.
Results
The 2 RCTs demonstrated a reduction (41.6% in 1 study and 71% in the other) in antibiotic prescription rate in the PCT-guided group versus the control group with no change in the number of days with impaired activity due to illness (9.0 vs 9.0 days [P = .96]; 8.1 vs 8.2 days [95% confidence interval −0.7 to 0.7]), number of days of work missed, and percentage of patients with persistent symptoms at 28 days. In the observational cohort studies, PCT did not consistently correlate with C-reactive protein, body temperature, and/or white blood cell counts.
Conclusions
The limited existing literature on the role of PCT in diagnosis, management, and prediction of clinical outcomes in ARS suggests that PCT-based guidelines for antibiotic prescription are a safe and effective method of minimizing unnecessary antibiotic use.</description><identifier>ISSN: 1945-8924</identifier><identifier>EISSN: 1945-8932</identifier><identifier>DOI: 10.1177/1945892418810293</identifier><identifier>PMID: 30871341</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Acute Disease ; Anti-Bacterial Agents - therapeutic use ; Biomarkers - blood ; C-Reactive Protein - metabolism ; Humans ; Original ; Procalcitonin - blood ; Rhinitis - blood ; Rhinitis - diagnosis ; Rhinitis - drug therapy ; Sinusitis - blood ; Sinusitis - diagnosis ; Sinusitis - drug therapy ; Treatment Outcome</subject><ispartof>American journal of rhinology & allergy, 2019-03, Vol.33 (2), p.103-112</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018 2018 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-7801696bcb9f24c0f89b8cad79bdaa6973c19976bf16b2df6c3000dfbd408e1f3</citedby><cites>FETCH-LOGICAL-c434t-7801696bcb9f24c0f89b8cad79bdaa6973c19976bf16b2df6c3000dfbd408e1f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1945892418810293$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1945892418810293$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,777,781,882,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30871341$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dilger, Amanda E.</creatorcontrib><creatorcontrib>Peters, Anju T.</creatorcontrib><creatorcontrib>Wunderink, Richard G.</creatorcontrib><creatorcontrib>Tan, Bruce K.</creatorcontrib><creatorcontrib>Kern, Robert C.</creatorcontrib><creatorcontrib>Conley, David B.</creatorcontrib><creatorcontrib>Welch, Kevin C.</creatorcontrib><creatorcontrib>Holl, Jane L.</creatorcontrib><creatorcontrib>Smith, Stephanie Shintani</creatorcontrib><title>Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review</title><title>American journal of rhinology & allergy</title><addtitle>Am J Rhinol Allergy</addtitle><description>Objectives
(1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in diagnosis of bacterial ARS.
Data Sources: PubMed and Embase.
Review Methods: A systematic search in the PubMed and Embase databases was performed to identify studies related to PCT as a biomarker in ARS. After critical appraisal of validity by 2 authors, 6 studies with a total of 313 patients were selected for data extraction and analysis. We identified 2 randomized control trials (RCTs) of PCT-based guidelines for antibiotic management of ARS in outpatient settings and 4 observational studies that compared PCT to other biomarkers in patients with ARS.
Results
The 2 RCTs demonstrated a reduction (41.6% in 1 study and 71% in the other) in antibiotic prescription rate in the PCT-guided group versus the control group with no change in the number of days with impaired activity due to illness (9.0 vs 9.0 days [P = .96]; 8.1 vs 8.2 days [95% confidence interval −0.7 to 0.7]), number of days of work missed, and percentage of patients with persistent symptoms at 28 days. In the observational cohort studies, PCT did not consistently correlate with C-reactive protein, body temperature, and/or white blood cell counts.
Conclusions
The limited existing literature on the role of PCT in diagnosis, management, and prediction of clinical outcomes in ARS suggests that PCT-based guidelines for antibiotic prescription are a safe and effective method of minimizing unnecessary antibiotic use.</description><subject>Acute Disease</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biomarkers - blood</subject><subject>C-Reactive Protein - metabolism</subject><subject>Humans</subject><subject>Original</subject><subject>Procalcitonin - blood</subject><subject>Rhinitis - blood</subject><subject>Rhinitis - diagnosis</subject><subject>Rhinitis - drug therapy</subject><subject>Sinusitis - blood</subject><subject>Sinusitis - diagnosis</subject><subject>Sinusitis - drug therapy</subject><subject>Treatment Outcome</subject><issn>1945-8924</issn><issn>1945-8932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UE1LAzEUDKLYWr17kj16Wc3bpNnEg1CLX1BQqp5DNpttU7ebmuxW-u_d0lpU8PQe82bmDYPQKeALgDS9BEH7XCQUOAecCLKHumso5oIk-7s9oR10FMIMY0b7FA5Rh2CeAqHQRcNn77Qqta1dZatIhUhFN9bNlX83PmqR8dRWLtiqCba24SoaRC-rUJu5qq2OxmZpzecxOihUGczJdvbQ293t6_AhHj3dPw4Ho1hTQus45RiYYJnORJFQjQsuMq5VnoosV4qJlGgQImVZASxL8oJpgjHOiyynmBsoSA9db3wXTTY3uTZV7VUpF962cVfSKSt_Xyo7lRO3lIwmwCBtDc63Bt59NCbUcm6DNmWpKuOaIBMQpI0o-qSl4g1VexeCN8XuDWC57l7-7b6VnP2MtxN8l90S4g0hqImRM9f4qq3rf8Mv1rONAg</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Dilger, Amanda E.</creator><creator>Peters, Anju T.</creator><creator>Wunderink, Richard G.</creator><creator>Tan, Bruce K.</creator><creator>Kern, Robert C.</creator><creator>Conley, David B.</creator><creator>Welch, Kevin C.</creator><creator>Holl, Jane L.</creator><creator>Smith, Stephanie Shintani</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190301</creationdate><title>Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review</title><author>Dilger, Amanda E. ; Peters, Anju T. ; Wunderink, Richard G. ; Tan, Bruce K. ; Kern, Robert C. ; Conley, David B. ; Welch, Kevin C. ; Holl, Jane L. ; Smith, Stephanie Shintani</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-7801696bcb9f24c0f89b8cad79bdaa6973c19976bf16b2df6c3000dfbd408e1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acute Disease</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biomarkers - blood</topic><topic>C-Reactive Protein - metabolism</topic><topic>Humans</topic><topic>Original</topic><topic>Procalcitonin - blood</topic><topic>Rhinitis - blood</topic><topic>Rhinitis - diagnosis</topic><topic>Rhinitis - drug therapy</topic><topic>Sinusitis - blood</topic><topic>Sinusitis - diagnosis</topic><topic>Sinusitis - drug therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dilger, Amanda E.</creatorcontrib><creatorcontrib>Peters, Anju T.</creatorcontrib><creatorcontrib>Wunderink, Richard G.</creatorcontrib><creatorcontrib>Tan, Bruce K.</creatorcontrib><creatorcontrib>Kern, Robert C.</creatorcontrib><creatorcontrib>Conley, David B.</creatorcontrib><creatorcontrib>Welch, Kevin C.</creatorcontrib><creatorcontrib>Holl, Jane L.</creatorcontrib><creatorcontrib>Smith, Stephanie Shintani</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of rhinology & allergy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dilger, Amanda E.</au><au>Peters, Anju T.</au><au>Wunderink, Richard G.</au><au>Tan, Bruce K.</au><au>Kern, Robert C.</au><au>Conley, David B.</au><au>Welch, Kevin C.</au><au>Holl, Jane L.</au><au>Smith, Stephanie Shintani</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review</atitle><jtitle>American journal of rhinology & allergy</jtitle><addtitle>Am J Rhinol Allergy</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>33</volume><issue>2</issue><spage>103</spage><epage>112</epage><pages>103-112</pages><issn>1945-8924</issn><eissn>1945-8932</eissn><abstract>Objectives
(1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in diagnosis of bacterial ARS.
Data Sources: PubMed and Embase.
Review Methods: A systematic search in the PubMed and Embase databases was performed to identify studies related to PCT as a biomarker in ARS. After critical appraisal of validity by 2 authors, 6 studies with a total of 313 patients were selected for data extraction and analysis. We identified 2 randomized control trials (RCTs) of PCT-based guidelines for antibiotic management of ARS in outpatient settings and 4 observational studies that compared PCT to other biomarkers in patients with ARS.
Results
The 2 RCTs demonstrated a reduction (41.6% in 1 study and 71% in the other) in antibiotic prescription rate in the PCT-guided group versus the control group with no change in the number of days with impaired activity due to illness (9.0 vs 9.0 days [P = .96]; 8.1 vs 8.2 days [95% confidence interval −0.7 to 0.7]), number of days of work missed, and percentage of patients with persistent symptoms at 28 days. In the observational cohort studies, PCT did not consistently correlate with C-reactive protein, body temperature, and/or white blood cell counts.
Conclusions
The limited existing literature on the role of PCT in diagnosis, management, and prediction of clinical outcomes in ARS suggests that PCT-based guidelines for antibiotic prescription are a safe and effective method of minimizing unnecessary antibiotic use.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>30871341</pmid><doi>10.1177/1945892418810293</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1945-8924 |
| ispartof | American journal of rhinology & allergy, 2019-03, Vol.33 (2), p.103-112 |
| issn | 1945-8924 1945-8932 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6421617 |
| source | MEDLINE; SAGE Complete A-Z List; Alma/SFX Local Collection |
| subjects | Acute Disease Anti-Bacterial Agents - therapeutic use Biomarkers - blood C-Reactive Protein - metabolism Humans Original Procalcitonin - blood Rhinitis - blood Rhinitis - diagnosis Rhinitis - drug therapy Sinusitis - blood Sinusitis - diagnosis Sinusitis - drug therapy Treatment Outcome |
| title | Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review |
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