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Procalcitonin and pyuria-based algorithm reduces antibiotic use in urinary tract infections: a randomized controlled trial

Overview of attention for article published in BMC Medicine, May 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)

Mentioned by

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22 tweeters
facebook
1 Facebook page
googleplus
1 Google+ user

Citations

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21 Dimensions

Readers on

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84 Mendeley
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Title
Procalcitonin and pyuria-based algorithm reduces antibiotic use in urinary tract infections: a randomized controlled trial
Published in
BMC Medicine, May 2015
DOI 10.1186/s12916-015-0347-y
Pubmed ID
Authors

Daniel Drozdov, Stefanie Schwarz, Alexander Kutz, Eva Grolimund, Anna Christina Rast, Deborah Steiner, Katharina Regez, Ursula Schild, Merih Guglielmetti, Antoinette Conca, Barbara Reutlinger, Cornelia Ottiger, Florian Buchkremer, Sebastian Haubitz, Claudine Blum, Andreas Huber, Ulrich Buergi, Philipp Schuetz, Andreas Bock, Christoph Andreas Fux, Beat Mueller, Werner Christian Albrich

Abstract

Urinary tract infections (UTIs) are common drivers of antibiotic use. The minimal effective duration of antibiotic therapy for UTIs is unknown, but any reduction is important to diminish selection pressure for antibiotic resistance, costs, and drug-related side-effects. The aim of this study was to investigate whether an algorithm based on procalcitonin (PCT) and quantitative pyuria reduces antibiotic exposure. From April 2012 to March 2014, we conducted a factorial design randomized controlled open-label trial. Immunocompetent adults with community-acquired non-catheter-related UTI were enrolled in the emergency department of a tertiary-care 600-bed hospital in northwestern Switzerland. Clinical presentation was used to guide initiation and duration of antibiotic therapy according to current guidelines (control group) or with a PCT-pyuria-based algorithm (PCT-pyuria group). The primary endpoint was overall antibiotic exposure within 90 days. Secondary endpoints included duration of the initial antibiotic therapy, persistent infection 7 days after end of therapy and 30 days after enrollment, recurrence and rehospitalizations within 90 days. Overall, 394 patients were screened, 228 met predefined exclusion criteria, 30 declined to participate, and 11 were not eligible. Of these, 125 (76% women) were enrolled in the intention-to-treat (ITT) analysis and 96 patients with microbiologically confirmed UTI constituted the per protocol group; 84 of 125 (67%) patients had a febrile UTI, 28 (22%) had bacteremia, 5 (4%) died, and 3 (2%) were lost to follow-up. Overall antibiotic exposure within 90 days was shorter in the PCT-pyuria group than in the control group (median 7.0 [IQR, 5.0-14.0] vs. 10.0 [IQR, 7.0-16.0] days, P = 0.011) in the ITT analysis. Mortality, rates of persistent infections, recurrences, and rehospitalizations were not different. A PCT-pyuria-based algorithm reduced antibiotic exposure by 30% when compared to current guidelines without apparent negative effects on clinical outcomes. Current controlled trials ISRCTN13663741 , date applied: 22/05/2012, date assigned: 03/07/2012, last edited: 28/01/2014.

Twitter Demographics

The data shown below were collected from the profiles of 22 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 84 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 1%
Unknown 83 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 23%
Researcher 10 12%
Other 10 12%
Student > Ph. D. Student 9 11%
Student > Doctoral Student 7 8%
Other 21 25%
Unknown 8 10%
Readers by discipline Count As %
Medicine and Dentistry 47 56%
Pharmacology, Toxicology and Pharmaceutical Science 8 10%
Nursing and Health Professions 5 6%
Agricultural and Biological Sciences 4 5%
Immunology and Microbiology 4 5%
Other 4 5%
Unknown 12 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 14. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 September 2016.
All research outputs
#1,090,427
of 13,142,497 outputs
Outputs from BMC Medicine
#890
of 2,094 outputs
Outputs of similar age
#24,752
of 226,856 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 13,142,497 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,094 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 34.8. This one has gotten more attention than average, scoring higher than 57% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 226,856 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them