Author Affiliations: Department of Emergency, Harvard School of Public Health, Boston, Massachusetts (Dr Schuetz); Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada (Dr Briel); and Department of Medicine, Inpatient Clinician Educator Service, Massachusetts General Hospital, Boston (Drs Chiappa and Greenwald).
The aims of our review were to summarize results of previous randomized controlled trials investigating the effects of procalcitonin protocols for antibiotic stewardship decisions, with particular focus on the different protocols used, and to propose clinical algorithms for use in future trials. We found that none of the trials reported increased rates of mortality or other adverse outcomes; yet, only 4 of them were noninferiority trials and adequately powered to address mortaility.1- 4 Mortality was also similar between groups in a pooled analysis using aggregate data of individual trials, but we agree with Ferrari et al that these results should be viewed with caution.
Schuetz P, Briel M, Chiappa V, Greenwald JL. Do Procalcitonin Algorithms Modify Mortality?—Reply. Arch Intern Med. 2012;172(2):197-198. doi:10.1001/archinte.172.2.198