Procalcitonin as a Biomarker in Rhinosinusitis

A Systematic Review

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)103-112
Number of pages10
JournalAmerican Journal of Rhinology and Allergy
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2019

Fingerprint

Calcitonin
Biomarkers
Anti-Bacterial Agents
PubMed
Observational Studies
Prescriptions
Guidelines
Information Storage and Retrieval
Body Temperature
Leukocyte Count
C-Reactive Protein
Cohort Studies
Outpatients
Databases
Confidence Intervals
Control Groups

Keywords

  • acute rhinosinusitis
  • biomakers
  • procalcitonin
  • systematic review

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

@article{1ab5164973254af6bdc7168041e5c600,
title = "Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review",
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.",
keywords = "acute rhinosinusitis, biomakers, procalcitonin, systematic review",
author = "Dilger, {Amanda E.} and Peters, {Anju Tripathi} and Wunderink, {Richard G} and Tan, {Bruce Kuang-Huay} and Kern, {Robert C} and {Conley Jr}, {David B} and Welch, {Kevin Christian} and Holl, {Jane Louise} and Smith, {Stephanie Shintani}",
year = "2019",
month = "3",
day = "1",
doi = "10.1177/1945892418810293",
language = "English (US)",
volume = "33",
pages = "103--112",
journal = "American Journal of Rhinology and Allergy",
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T1 - Procalcitonin as a Biomarker in Rhinosinusitis

T2 - A Systematic Review

AU - Dilger, Amanda E.

AU - Peters, Anju Tripathi

AU - Wunderink, Richard G

AU - Tan, Bruce Kuang-Huay

AU - Kern, Robert C

AU - Conley Jr, David B

AU - Welch, Kevin Christian

AU - Holl, Jane Louise

AU - Smith, Stephanie Shintani

PY - 2019/3/1

Y1 - 2019/3/1

N2 - 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.

AB - 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.

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