久志本成樹先生

第42回日本集中治療医学会学術集会
The 42nd Annual Meeting of the Japanese Society of Intensive Care Medicine
日時
2015年2月9日
（月）
12：40 ∼ 13：40
場所
第2会場ホテル日航東京 1F ペガサスC
教育セミナー2（LS2）
How to use Procalcitonin for diagnosis of
sepsis and to guide antibiotic therapy
座長
久志本成樹先生
東北大学大学院医学系研究科外科病態学講座救急医学分野教授
東北大学病院救急科科長/高度救命救急センター部長
演者
PD Dr. med. habil.
Michael G Meisner
Clinic of Anaesthesiology and Intensive Care Medicine,
Städtisches Krankenhaus Dresden-Neustadt, Germany
本セミナーは整理券制となります。
【配布日時・場所】
・2/9
（月）
7:45∼12:10
・ホテル日航東京 1F ロビー
※整理券はセミナー開始後無効となります。
※整理券は該当教育セミナーが開催される施設においてのみ配布となります。
共催
第42回日本集中治療医学会学術集会／
サーモフィッシャーサイエンティフィック株式会社
第42回日本集中治療医学会学術集会
The 42nd Annual Meeting of the Japanese Society of Intensive Care Medicine
教育セミナー2（LS2）
How to use Procalcitonin for diagnosis of
sepsis and to guide antibiotic therapy
PD Dr. med. habil.
Michael G Meisner
Clinic of Anaesthesiology and Intensive Care Medicine,
Städtisches Krankenhaus Dresden-Neustadt, Germany
The Procalcitonin (PCT) is used as marker for the diagnosis of sepsis. This has direct consequences for therapy: High levels suggest immediate search for a possible focus of infection or
source of inflammation and antibiotic therapy. Normal levels indicate that severe systemic
inflammation is not present or infection is only local or colonisation. In this case there is more
time for a specific diagnostic work-up before antibiotics are given or calculated antibiotic therapy can be stopped if sepsis is not confirmed during the work-up. This approach is supported
by the SCCM guidelines as well. Supported by various clinical studies and experience, in our
ICU we interprete plasma levels and kinetic of PCT to supervise efficacy of antibiotic therapy
and to adapt the duration of treatment periods individually to the requirements of the patient: (i)
a PCT decline or increase during day 1 – 3 indicates the response of systemic inflammation to
therapy, (ii) during day 3 to 7 consistently declining or regression to normal levels support a
recommendation to stop antibiotic therapy, if there is no sepsis and the focus has been eliminated successfully and (iii) – concluded from these studies - we added a basic rule to stop antibiotic therapy latest on day 7 of treatment, if there are no specific reasons to continue, which
must be interdisciplinary discussed and documented in the team. This way, a significant
number of patients can be treated without antibiotics on the ICU and treatment cycles of antibiotics are short, since they are adapated to the putative focus and the individual requirements
of the patients.
共催
第42回日本集中治療医学会学術集会／サーモフィッシャーサイエンティフィック株式会社

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