The use of procalcitonin in patients with pyogenic liver abscesses
DOI:
https://doi.org/10.34287/MMT.1(52).2022.6Abstract
The results of treatment of 79 patients with pyogenic liver abscesses (AP) were analyzed. Sepsis was diagnosed in 10 (16.1%) patients. Procalcitonin (PCT) levels were used to diagnose sepsis. The duration of antibacterial therapy (ABT) was based on the determination of PCT and the patient's clinical condition. The decision to prescribe or abstain from ABT should be reviewed within the next 6-24 hours based on the patient's clinical condition and PCT level. These values should also be taken into account in the decision-making process regarding the duration of ABT, as well as the clinical course of the disease. There were no fatalities in the treatment of AP.
Purpose of the study. To determine the diagnostic and prognostic significance of procalcitonin in patients with pyogenic liver abscesses.
Materials and methods. The results of treatment of 79 patients with pyogenic liver abscesses were analyzed. The mean age of patients was 48.4 ± 4.7 years, with men predominating (62.9%). The inclusion criterion was the presence of pyogenic liver abscesses, the exclusion criteria were cholangiogenic and specific abscesses. The main group consisted of 44 patients who received comprehensive conservative therapy, taking into account antibacterial treatment, the duration of which was determined by determining the level of PСT. Patients in the control group (35 patients) did not differ from the main in age, sex, comorbidities, severity of the disease and the results of microbiological examination, but received conventional ABT.
Results. Carrying out adequate combined antibiotic therapy in patients with AP by determining PKT, along with surgery, reduced the recovery time of patients: 2-3 days normalization of body temperature (t = 5.66176; P <0.000001) and leukocyte formula (t = 8,56860; P <0,000001) patients of the main group compared with control patients
Conclusion. Conducting ABT by determining the level of PСT contributed to a probable reduction in the length of stay in the hospital for 3 days (t = 3.95561; P = 0.000116).
References
Boyko VV, Tyicschenko OV, Smachilo RM, [ta in.]. Likuvannya abscessiv pechinki Oryiginal’ni doslidzhennya. 2018; 2: 10–15.
Bushlanov PS, Merzlikin PV, Semichev YeM [i dr.] Sovremennyye tendentsii v lechenii abstsessov pecheni Vestnik khirurgii im. 2018; 6: 87–90.
Polyakova AS, Bakradze DM, Ivanov AV [i dr.] Diagnosticheskaya tsennost' opredeleniya urovnya prokal'tsitonina v praktike infektsionista Voprosy sovremennoy pediatrii. 2017; 16: 334–341.
Klishin AA, Kosul'nikov SO, Kutovoy AB, [i dr.] Opyt lecheniya abstsessov pecheni. Klinicheskaya meditsina. 2018; 2: 59–62.
Polyatsko KH. Hostri bakterialʹni abstsesy pechinky: osoblyvosti diahnostyky ta likuvannya Shpytalʹna khirurhiya. 2016; 1: 79–81.
Shaprynsʹkyy VO, Makarov VM, Kaminsʹkyy OA. Abstsesy pechinky: diahnostyka ta pidkhody do likuvannya Klinichna anatomiya ta operatyvna khirurhiya. 2019; 2: 8–10.
Agarwal R, Schwartz DN. Procalcitonin to guide duration of antimicrobial therapy in intensive care units: a systematic review. Clin Infect Dis. .2011; 53 (4): 379–387.
De Jong A JA, van Oers [et al.] Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial. The Lancet Infectious Diseases. 2016; 7: 1–9.
Hagiya H, Kimura K, Nishi I, Tomono K. Liver abscess caused by Gram-negative spiral bacilli. J.M.M. Case Rep. 2018; 8: 5 (7).
Ontanilla G, Herrera JM, Alcívar JM, [et al.] Liver abscess due to Klebsiella pneumoniae and its relation to colon lesions Rev. Esp. Enferm. Dig. 2015; 107 (1): 51–52.
dos SM, Otto HS. Lunardelli and Ribeiro-Junior Marcelo AF. Pyogenic liver abscess: Diagnostic and therapeutic management Arq Bras Cir Dig. 2016; 29 (3): 194–197.
Chen YH, Li YH, Lin YJ [et al.] Prognostic Factors and Visual Outcomes of Pyogenic Liver Abscess-Related Endogenous Klebsiella pneumoniae Endophthalmitis: A 20-year retrospective review Sci Rep.2019; 9(1): 1071.
Zhang J, Du Z, Bi J J [et al.].The impact of previous abdominal surgery on clinical characteristics and prognosis of pyogenic liver abscess: A 10-year retrospective study of 392 patients .Medicine (Baltimore). 2018 ; 97 (39).
Milcent K, [et al.] Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrie Infants JAMA Pediatr. 2016; 170 (1): 62–69.
