The Value Of The Decrease Rate Of Serum Procalcitonin In Evaluating The Effect About The Early Experiential Use Of Antibiotic In Sepsis

Objective To explore the value of the decrease rate of serum procalcitonin in evaluating the effect about the early experiential use of antibiotic in sepsis.Methods It was a retrospective analysis of clinical cases. A total of 40 patients with sepsis administrated in the respiratory department of our hospital from January 2010 to January 2015 were divided into two groups according to the results of the blood culture. The patients which were treated with the same antibiotics as the results of the blood culture were belonged to Group A, the others who used the different drugs form the results of the blood culture were distributed to Group B. Procalcitonin(PCT), White Blood Cell count(WBC), Neutrophil percentage(Neu%)were evaluated in all patients before the experiential use of antibiotic, and all the indicators were measured again at the third and fifth day after the treatment of the antibiotics. Calculate the decrease rates of the PCT 、WBC and Neu%, then compare the difference of all the indexes between the two groups. Finally use the Receiver Operating Characteristic Curve(ROC curve) to evaluate the predictive ability of the decrease rates of the PCT 、WBC and Neu% in evaluating the effect about the early experiential use of antibiotic in sepsis.Results(1)No apparent difference was found in the age, gender, underlying disease, nor the bacteria species(P>0.05).(2)There was no significant difference in PCT 、WBC nor Neu% between the two groups at the first day(P>0.05). At the third day after the experiential use of antibiotic, the decrease rate of PCT of group A(78.425±8.009)% was obviously higher than that of group B(42.695±16.175)%(P<0.05). The decrease rate of WBC was(28.783±20.834)% in Group A and(23.620±13.091)% in Group B. The decrease rate of Neu% was(9.177±7.466)% in Group A and(8.095±6.241)% in Group B. At the fifth day after the experiential use of antibiotic, the decrease rate of PCT of group A(72.800±8.027)% was still higher than that of group B(43.511±15.509)%(P<0.05). The decrease rate of WBC was(17.793±13.066)% in Group A and(22.272±12.902)% in Group B. The decrease rate of Neu% was(9.930±8.311)% in Group A and(9.266±5.97)% in Group B. No apparent difference was found in the decrease rates of WBC or Neu% between the two groups(P>0.05).(3)At the third and fifth day after the treatment of the antibiotics, the area under the ROC curve of the decrease rate of PCT were obviously higher(0.978 、0.948) than that of WBC(0.564 、0.376) and Neu%(0.529 、0.469). The specificity and sensibility of the decrease rate of PCT were 0.95 and 0.9 in the third day while that were 0.9 and 0.95 in the fifth day.Conclusion(1)The serum procalcitonin is a new indicator of the infectious disease which has a high sensibility and specificity.(2)The decrease rate of PCT can be used to evaluate the effect about the early experiential use of antibiotic in sepsis, and the value is superior to that of WBC and Neu%.