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Research unit
FSVO
Project number
1.20.03
Project title
Evaluation of plasma procalcitonin kinetics in dogs with bacterial infections for the development of an individualised procalcitonin-guided antimicrobial therapy

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Short description
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Project aims
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CategoryText
Key words
(German)

Antimicrobial Stewardship, Procalcitonin, Individualisierte antimikrobielleTherapie

Key words
(English)

Antimicrobial Stewardship, procalcitonin, individualised antimicrobial therapy

Short description
(German)

Antibiotika (AB) sind essentiell für die moderne Medizin und AB-Resistenz stellt eine globale Bedrohung für die Gesundheit von Mensch und Tier dar. Procalcitonin (PCT) ist ein Serummarker für bakterielle Infektionen. Beim Menschen kann durch PCT-geführte AB Therapie die Therapiedauer ohne Anstieg der Morbidität und Mortalität verkürzt werden. Unsere Hypothese ist, dass individualisierte Biomarker-geführte AB Therapie bei Hunden mit bakteriellen Infektionen ebenfalls zu einer Verkürzung der Therapiedauer führt.

In diesem Projekt werden wir den klinischen Nutzen von Plasma PCT als Therapieentscheidungshilfe beim Hund evaluieren. Im ersten Schritt wird die Plasma PCT Kinetik bei Hunden mit bakteriellen Infektionen untersucht, Schwellenwerte und Algorithmen für eine PCT-geführte AB Therapie ermittelt und Möglichkeiten eines Point-of-care Systems zur Messung von caninem PCT exploriert. Die Resultate dieser Studie sind die Grundlage zukünftiger interventioneller Studien zum Vergleich von Behandlungserfolg und Behandlungsdauer von PCT-geführter und konventioneller AB Therapie.

Short description
(English)

Antimicrobials (AM) are vital to modern medicine and antimicrobial resistance is a global threat to human and animal health. Procalcitonin (PCT) is a serum marker of bacterial infection in humans and PCT-guided AM therapy has been shown to shorten the duration of AM treatment without increase in morbidity or mortality. We hypothesise that individualised biomarker-guided AM therapy will lead to an overall reduction in treatment duration in dogs with bacterial infections.

In this project we propose to assess the clinical utility of the plasma marker procalcitonin (PCT) to guide AM therapy in dogs. In a first step, we will study PCT plasma kinetics in dogs with bacterial infections, determine cut-off criteria and algorithms for PCT-guided AM therapy and explore possibilities for a point-of-care system for the measurement of PCT. The results of this study are the basis for future prospective interventional clinical trials to compare clinical outcomes of PCT-guided against conventional antibiotic therapy and determine whether biomarker-guided therapy leads to a shortening of AM treatments in dogs.

Project aims
(English)

We hypothesise that:

  1. Plasma PCT is elevated in dogs with bacterial infections compared to non-bacterial disease and healthy controls.

  2. Plasma PCT concentrations in dogs with bacterial infections decrease with clinical resolution of infection.

  3. Early and sustained decrease of PCT is associated with a good treatment response, an uncomplicated recovery and reduced mortality risk.

 

To test our hypotheses, we will:

  1. Evaluate plasma PCT kinetics in healthy dogs, dogs with bacterial infections including bacterial pneumonia, acute haemorrhagic diarrhoea, septic peritonitis and systemic sepsis and relevant diseased controls without bacterial infection (Hypothesis 1; specific aim 1).

     

  2. Perform serial measurements of plasma PCT in all included populations and examine possible correlations of plasma PCT with disease severity, clinical, laboratory and imaging-based markers of disease progression (Hypothesis 2; specific aim 1).

     

  3. Determine correlations of plasma PCT with clinical outcome including complication rates, duration of hospitalisation and mortality (Hypothesis 3, specific aim 1).

 

To develop PCT as a clinically applicable ASP tool, we will:
4. Determine appropriate cut-offs for plasma PCT concentrations and develop algorithms for biomarker guided AM therapy for dogs with confirmed bacterial infections based on the results of aims 1-3 (specific aim 2). Dogs with acute haemorrhagic diarrhoea and bacterial pneumonia lacking confirmation by bacterial culture will not be included in these analyses to omit the risk of misclassification.
5. Explore methods for rapid detection of PCT in patient blood (point-of-care test) (specific aim 3).

Publications / Results
(German)
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URL-addresses
(German)