OBJECTIVETo evaluate the value of serum procalcitonin (PCT) for the guidance of antibiotic therapy in children with lower respiratory tract infection (LRTI).

METHODSA prospective randomized controlled study was conducted in 396 children with LRTI who visited Weifang Maternity and Child Care Hospital. The participants were randomly assigned into a PCT group in which the antibiotic therapy was guided by serum PCT level and a control group in which the standard therapy was given according to clinical guidance. Afterwards, a subgroup analysis was performed according to whether the patient was diagnosed with community-acquired pneumonia (CAP). After 14-day treatment, antibiotic prescription rate, duration of antibiotic treatment, and side events were compared between the groups.

RESULTSA total of 396 cases were recruited and equally assigned into the PCT group and the control group, among whom the numbers of the children with CAP were 125 and 123, respectively. The mean duration of antibiotic treatment was significantly shorter in the PCT group than in the control group (P<0.05). The subgroup analysis showed that the duration of antibiotic treatment in both CAP and non-CAP PCT subgroups was significantly shorter than in the control subgroups (P<0.05), however, the antibiotic prescription rate in the non-CAP PCT subgroup was significantly higher than that in the non-CAP control subgroup (P<0.05). There were no differences in the rate and duration of side events from antibiotic therapy, hospitalization rate, the length of hospital stay, and safety between the PCT and control groups.

CONCLISOPNSSerum PCT-based guidelines on antibiotic use can shorten the duration of antibiotic therapy in children with LRTI.