BMJ子刊：降钙素原可用作发热性中性粒细胞减少症(FN)患者的抗生素停用指标吗？

2022-03-23 网络网络

发热性中性粒细胞减少症(FN)是儿童和年轻人癌症治疗的常见并发症，许多患者发作的原因是抗生素过度治疗。降钙素原可能是一个预测指标，以指导那些低风险严重细菌感染患者停用抗生素。在这一人群中进行支持性护理

发热性中性粒细胞减少症(FN)是儿童和年轻人癌症治疗的常见并发症，许多患者发作的原因是抗生素过度治疗。降钙素原可能是一个预测指标，以指导那些低风险严重细菌感染患者停用抗生素。在这一人群中进行支持性护理试验已被证明是困难的。这项单臂初步研究（PAnTher Cub）旨在评估在儿童FN患者中用降钙素原（PCT）来判断抗生素停用的可行性。

在FN发作期间进行每日降钙素原水平检测，并给出明确的抗生素停用指导。分析是描述性的。

在32名患者及其家属中，28名患者同意，13名患者出现发热性中性粒细胞减少症。该研究共纳入了16个病例。所有相关的FN发作均已采集数据，并收集足够的数据。没有发生重大安全事件。在4/8（50%）没有明确的微生物记录或临床感染的病例中，抗生素的持续时间或范围都有所缩短。对专业人士的采访揭示了研究的重要性、研究团队中关键个人的价值、该方案的特殊挑战以及研究改进建议。

个体患者的连续PCT测量

作为一项单臂试点研究，PAnTherCub是评估PCT指导的FN管理在儿科血液学/肿瘤学中的使用的第一步。下一阶段的研究将包括可行性研究，探索与多个研究地点、患者随机化(到对照组)相关的问题，并确定确定研究所需的样本量。最后阶段将是一个更大的随机对照试验，以评估降钙素原引导方法的使用。

PAnTherCub已经证明，评估PCT指导的儿科FN方法的研究是可能的，并受到儿科血液学/肿瘤学界的欢迎。没有关于安全事件的报道。已经提供了与实施相关的初步结果数据和定性数据，以进一步促进未来的研究设计。

参考文献：Morgan JE, Phillips B PAnTher Cub: procalcitonin-guided antibiotic therapy for febrile neutropenia in children and young people with cancer - a single-arm pilot study BMJ Paediatrics Open 2022;6:e001339. doi: 10.1136/bmjpo-2021-001339

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2022-07-11 soongzhihua

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2023-01-05 gaoxiaoe

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2022-03-22 wrj0121

#降钙素原#

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2022-03-22 yykkxiaodou

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