ESR 2.4
SAPS-II: Exploring the use of procalcitonin as a marker of infection resolution in critically ill

Project

Procalcitonin (PCT) is an established biomarker that provides unique additional information on the severity of bacterial infection. Several smaller clinical trials have demonstrated that daily PCT-monitoring helps identify resolution of bacterial infection. Recently the largest study on PCT, the Dutch SAPS-I trial has been concluded. SAPS-I clearly demonstrated reduced antibiotic use with under PCT-guidance.
The next trial, SAPS-II, we plan to conduct in Dutch, German and Belgian ICU’s. The goal of SAPS-II is to verify with PCT-measurements if continuous antibiotic infusion is superior to conventional intermittent infusion. If continuous antibiotic administration leads to more rapid clearance of infection, this may constitute a next step in reducing antibiotic treatment duration. The key hypothesis to be tested in SAPS-II is that PCT will decrease earlier in patients with continuous antibiotic administration compared with intermittent administration.

Supervisors

  • Maarten Nijsten (Dpt of Critical Care, UMC Groningen, Netherlands)
  • Dr. ir. H.J.M. Harmsen, Molecular Bacteriology, MMBI, UMCG

Collaborations

Bhanu Sinha (Medical Microbiology, UMC Groningen, Netherlands)
Dylan de Lange (Dpt of Critical Care, UMC Utrecht, Netherlands)
ThermoFisher Scientific, the Netherlands

Relevant publications

  1. de Jong E, van Oers JA, Beishuizen A, Vos P, Vermeijden WJ, Haas LE, et al. Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients. LANCET Infect Dis. 2016 Mar 2.
  2. Dik J-WH, Hendrix R, Poelman R, Niesters HG, Postma MJ, Sinha B, et al. Measuring the impact of antimicrobial stewardship programs. Expert Rev Anti Infect Ther. 2016 Jun;14(6):569–75.
  3. Nijsten MWN, Olinga P, The TH, de Vries EGE, Groothuis GMM, Limburg PC, et al. Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro. Crit Care Med. 2000 Feb;28(2):458–61.

Keywords

antimicrobial resistance, therapeutic drug monitoring, biomarkers, trial design, procalcitonin, antibiotic stewardship