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Open Access Maced J Med Sci. 2017 Dec 15; 5(7):909-914. 909
ID Design 2012/DOOEL Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2017 Dec 15; 5(7):909-914.
https://doi.org/10.3889/oamjms.2017.194
eISSN: 1857-9655
Clinical Science
The Predictive Role of Procalcitonin On the Treatment of Intra-
Abdominal Infections
Dafina Mahmutaj
1*
, Shaip Krasniqi
2
, Bedri Braha
1
, Dalip Limani
1
, Burim Neziri
2
1
Clinic of Surgery, University Clinical Center of Kosovo, Hospital and University Clinical Service of Kosovo, Prishtina,
Kosovo;
2
Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo
Citation: Mahmutaj D, Krasniqi S, Braha B, Limani D,
Neziri B. The Predictive Role of Procalcitonin On the
Treatment of Intra-Abdominal Infections. Open Access
Maced J Med Sci. 2017 Dec 15; 5(7):909-914.
https://doi.org/10.3889/oamjms.2017.194
Keywords: intraabdominal infections; procalcitonin;
antibiotic; microbiological examination; CRP.
*Correspondence: Bedri Braha, MD MsC. Clinic of
Surgery, University Clinical Center of Kosovo, Hospital
and University Clinical Service of Kosovo Prishtina,
Kosovo. E-mail: dafinamahmutaj@gmail.com
Received: 07-Aug-2017; Revised: 20-Sep-2017;
Accepted: 21-Oct-2017; Online first: 24-Nov-2017
Copyright: © 2017 Dafina Mahmutaj, Shaip Krasniqi,
Bedri Braha, Dalip Limani, Burim Neziri. This is an open-
access article distributed under the terms of the Creative
Commons Attribution-NonCommercial 4.0 International
License (CC BY-NC 4.0).
Funding: This research did not receive any financial
support.
Competing Interests: The authors have declared that no
competing interests exist.
Abstract
Aim: This study aims to evaluate the algorithm of procalcitonin (PCT) and its role on the duration of antibiotics
prescription for intra-abdominal infections.
Materials and Methods: This study is a prospective controlled study that is conducted in groups of 50
hospitalised patients and 50 controlled group patients.
Results: The results indicated that the average duration of antibiotic delivery to the PCT group was -10.6 days
(SD ± 6.6 days), while in the control group -13.2 days (SD ± 4.2 days). These data showed a significant difference
in the duration of antibiotic therapy and the monitoring role of PCTs in the prediction success of antibiotic
treatment. The antibiotic delivery was longer in the septic shock 17 (SD ± 11.7) that corresponds to high PCT
values of 67.8 (SD ± 50.9). Recurrence of the infection after the cessation of antibiotics occurred in 2 cases (4%)
in the standard group, while it occurred in 3 cases (6%) in the control group.
Conclusion: The treatment of the intra-abdominal infections based on the PCT algorithm shortens the duration of
antibiotic treatment and does not pose a risk for the recurrence of the infection.
Introduction
Intra-abdominal infections are a group of
diseases with a relatively high degree of mortality and
morbidity. Two determinants for the successful
treatment of intra-abdominal infections are the
identification of the source of the infection and the
speed at which the empirical delivery of antibiotics
begins, circumstances that reduce the risk of
complications and mortality [1]. Reduction of mortality
is not possible without effective control of the source
of infection [2]. The mortality rate of intra-abdominal
infections was about 90% at the end of the 19th
century, where management was mostly non-
operative. In recent years, surgical intervention in
intra-abdominal infections has influenced the control
of the source of infection by reducing the mortality rate
about 30% in cases of severe sepsis and septic shock
[3-5]. Reduction of mortality rate is achieved with the
earliest diagnostics of these infections and timely and
adequate treatment [6-8].
Antibiotic therapy should start immediately
after the intraabdominal infection diagnosis, while the
duration of administration of antibiotics is a matter of
ongoing discussion and there is still no consensus [8].
Treatment protocols recommend empirical
antimicrobial therapy that is effective against the
enterococcus, staphylococcus and the candida [6, 7].
If the empirical antibiotic is inadequate, it is followed
by failure of treatment, an extension of hospitalisation
and death. Non-rational antibiotic delivery leads to
increased resistance to antibiotics and the
appearance of intrahospital infections [8]. Therefore it
is recommended to restrict the use of antibiotics and
apply the biomarker algorithm in treatment to monitor
the success of antibiotic therapy and discontinuation
of their ordination as earliest [9, 10]. In Intensive Care
Department, the procalcitonin (PCT) serial
measurement can be used as a guide to facilitate the