Use of Procalcitonin to Guide Discontinuation of Antimicrobial Therapy in Patients with Persistent Intra-Abdominal Collections: A Case Series
Table 1
Demographic characteristics, clinical manifestations, and outcomes of patients with intra-abdominal abscess.
Patient 1
Patient 2
Patient 3
Patient 4
Age
70
63
31
74
Sex
Male
Female
Male
Male
Race
White
Black
Black
White
Admission labs
WBC, 1000 per mm3
9.6
14.5
14.4
9.4
Platelets, 1000 per mm3
360
321
359
285
Lactate, mmol/L
2.3
5.9
5.7
2.5
Isolated bacteria
Staphylococcus epidermidis (blood)
Escherichia coli, Streptococcus anginosus
Eikenella corrodens, Bacteroides fragilis
Staphylococcus epidermidis
Suspected site of origin
Small bowel
Perinephric abscess
Colon vs appendix
Liver and kidney cysts
Procedure to control the source of infection
Percutaneous drainage
Percutaneous drainage
Percutaneous drainage
Percutaneous drainage
Abscess size (cm) at diagnosis
11.6 × 7.4
5.3 × 3.8
5.7 × 6.2 (psoas), 4.1 × 4.4 (mesenteric)
19.3 × 15.3
Abscess size (cm) when antimicrobials were stopped
9.1 × 5.5
3.2 × 1.8
4.1 × 4.2 (mesenteric)
11.8 × 12.5
Procalcitonin levels (ng/mL) when antimicrobials were stopped
0.07
0.05
0.03
0.04
Total duration of antimicrobial therapy (days)
39
93
54
73
Length of hospital stay (days)
7
41
7
12
Readmission at 30 days
No
No
No
No
Mortality
30-day
No
No
No
No
90-day
No
No
No
No
180-day
No
No
No
No
1-year
No
No
No
N/A
aThe total duration of antimicrobial therapy was defined as the sum of calendar days of inpatient plus postdischarge antimicrobial administration. WBC, white blood cells.
