Fast PCR tests in UCI improve the use of antibiotics – microbiology

Image: Fast PCR tests in the ICU could not prove non -refiriority in clinical treatment of pneumonia (photo with kind permission of shelttersock)

A study of cooperation led by the University of Plymouth (Devon, Great Britain) has shown that the tests of rapid test chain reactions (PCR) in the intensive care unit (UCI) improved the use of antibiotics compared to standard attention, although they did not show non -refiniority in clinical treatment of pneumonia.

The WP3 test, a randomized, pragmatic, open and multicentric controlled study, evaluated the impact of rapid PCR syndomic tests on the ICU in the face of standard microbiological tests based on the use of antibiotics and clinical results in the hospital acquired by pneumonia (NA) and pneumonia associated with mechanical ventilation (NAVI). The study included 453 adults (middle age, 61 years) and 92 children (Middle Ages, 7.5 months) with NA or NAVM, who were planning to start empirical treatment of antibiotics or were going to modify their current therapy. Participants were randomly assigned to get a rapid PCR syndromic test in the ICU or a standard microbiological test. The evaluated primary results were: superiority in the use of antibiotics 24 hours after randomization, defined as the proportion of patients who received suitable and adequate antibiotic therapy, and not the inferiority in the treatment of clinical pneumonia after 14 days, defined as the absence of death, septic shock, septic shock, septic shock.

Secondary results included mortality after 28 days, occurrence of septic shock, changes in the score of organic dysfunction and hypersensitivity to antibiotics. Published in Intensive careThe study found that the intervention group achieved higher administration of antibiotics compared to the control group (76.5 %compared to 55.9 %; probability ratio, 2.57; 95 %CI, 1.77-3.73). However, independence in clinical healing has not been proven because the intervention group showed a lower level of clinical healing after 14 days (56.7 %) compared to the control group (64.5 %). In addition, there were no significant differences between groups with regard to organic dysfunction, 28 -day mortality or adverse effects associated with antibiotics, including septic clash, severe hypersensitivity to antibiotics and secondary pneumonia.

“We recommend that the use of syndromic PCR to reduce antibiotic treatment carefully. We do not recommend modifying the current regulation strategies until more data is available,” the scientists said.