Objectives: This study was to assess clinical effectiveness on determining discontinuation of antibiotics based on procalcitonin levels in sepsis suspected patients. Methods: Existing systematic review search was performed based on the pre-established strategy in various databases including EMBASE, Ovid-Medline, and KoreaMed. Prkno et al. (2013) was selected considering comprehensiveness of literature search, research scope, as well as the Assessment of Multiple Systematic Reviews (AMSTAR) score. Using the search strategy of the selected study, additional systematic search was conducted to identify randomized clinical trials (RCT) that compare the effectiveness of procalcitonin-based antibiotics therapy with standard care. In order to evaluate the quality of studies, the risk of bias assessment tool was used. All database search and quality assessment were conducted by two reviewers independently. Metaanalysis was performed using a random-effect model. Results: A total of 8 RCTs were included. Duration of antibiotic therapy was significantly reduced in procalcitonin-guided therapy group, compared to standard treatment group (mean difference, -2.43; 95% confidence interval, -3.46, -1.40), while 28-day mortality, hospital mortality, and length of stay did not show any significant difference. Conclusion: Procalcitonin-guided therapy shortened duration of antibiotic treatment compared to standard care without any harmful effect on other clinical outcomes such as mortality or length of hospital stay.
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