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Abbildung 1: Schematische Darstellung von Procalcitonin (nach Meisner, 2000)....13 Abbildung 2: Relation der ermittelten Punktzahl im „New Simplified Acute

Physiology Score“ (SAPS II) zur Sterbewahrscheinlichkeit in Prozent...22 Abbildung 3: Der Sequential Organ Failure Assessment (SOFA) - Score (Mittelwert

± Standardabweichung) der Gruppe mit Procalcitonin-gesteuerter

Antibiotikatherapie (offene Kreise) und der Kontrollgruppe mit standardisierter Behandlungsdauer der Antibiotikatherapie über 8 Tage (geschlossene Kreise)..32 Abbildung 4: Die Leukozytenwerte (Mittelwert ± Standardabweichung) der

Gruppe mit Procalcitonin-gesteuerter Antibiotikatherapie (offene Kreise) und der Kontrollgruppe mit standardisierter Behandlungsdauer der

Antibiotikatherapie über 8 Tage (geschlossene Kreise)...33 Abbildung 5: Interleukin 6 (IL-6) Werte (Mittelwert ± Standardabweichung) der

Gruppe mit Procalcitonin-gesteuerter Antibiotikatherapie (offene Kreise) und der Kontrollgruppe mit standardisierter Behandlungsdauer der

Antibiotikatherapie über 8 Tage (geschlossene Kreise)...34 Abbildung 6: C-reaktives Protein (CRP) Werte (Mittelwert ± Standardabweichung)

der Gruppe mit Procalcitonin-gesteuerter Antibiotikatherapie (offene Kreise) und der Kontrollgruppe mit standardisierter Behandlungsdauer der

Antibiotikatherapie über 8 Tage (geschlossene Kreise)...35 Abbildung 7: Procalcitonin (PCT) Werte (Mittelwert ± Standardabweichung) der

Gruppe mit Procalcitonin-gesteuerter Antibiotikatherapie (offene Kreise) und der Kontrollgruppe mit standardisierter Behandlungsdauer der

Antibiotikatherapie über 8 Tage (geschlossene Kreise)...36 Abbildung 8: PCT-Werte der PCT-Gruppe im Verlauf über 8 Tage als Boxplots mit

Median, oberem und unterem Quartil, 0,1 und 0,9 Quantil (Whisker) und

Ausreißern (Punkte)...38

Tabelle 1: Vergleich der Kriterien von SAPS II und SOFA; nicht erfasst: - ...23 Tabelle 2: Demographische und klinische Daten; jeweils Mittelwert

± Standardabweichung...31 Tabelle 3: Angewendete Antibiotika, Häufigkeit in Prozent und Therapiedauer in

Tagen...37

8. Literaturverzeichnis

Aikawa N, Fujishima S, Endo S, Sekine I, Kogawa K, Yamamoto Y, Kushimoto S, Yukioka H, Kato N, Totsuka K, Kikuchi K, Ikeda T, Ikeda K, Harada K, Satomura S. Multicenter prospective study of procalcitonin as an indicator of sepsis. J Infect Chemother 2005; 11: 152-159.

Aouifi A, Piriou V, Bastien O, Blanc P, Bouvier H, Evans R, Celard M, Vandenesch F, Rousson R, Lehot JJ. Usefulness of procalcitonin for diagnosis of infection in cardiac surgical patients. Crit Care Med 2000; 28: 3171-3176.

Arkader R, Troster EJ, Lopes MR, Junior RR, Carcillo JA, Leone C, Okay TS.

Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome. Arch Dis Child 2006; 91: 117-120.

Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 1993;

341: 515-518.

Barati M, Alinejad F, Bahar MA, Tabrisi MS, Shamshiri AR, Bodouhi N, Karimi H.

Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns 2008; 34: 770-774.

Bell K, Wattie M, Byth K, Silvestrini R, Clark P, Stachowski E, Benson EM.

Procalcitonin: a marker of bacteraemia in SIRS. Anaesth Intensive Care 2003;

31: 629-636.

Bergogne-Bérézin E. Treatment and prevention of antibiotic associated diarrhea. Int J Antimicrob Agents 2000; 16: 521-526.

Bodí M, Ardanuy C, Olona M, Castander D, Diaz E, Rello J. Therapy of ventilator-associated pneumonia: The Tarragona strategy. Clin Microbiol Infect 2001; 7: 32-33.

Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM,

Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. the ACCP/SCCM Consensus Conference

Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101: 1644-1655.

Brun-Buisson C. The epidemiology of the systemic inflammatory response.

Intensive Care Med 2000; 26 Suppl 1: 64-74.

Brunkhorst FM, Wegscheider K, Forycki ZF, Brunkhorst R. Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis, and septic shock.

Intensive Care Med 2000; 26 Suppl 2: 148-152.

Castella X, Artigas A, Bion J, Kari A. A comparison of severity of illness scoring systems for intensive care unit patients: results of a multicenter, multinational study. the European/North American Severity Study Group. Crit Care Med 1995;

23: 1327-1335.

Charles PE, Dalle F, Aube H, Doise JM, Quenot JP, Aho LS, Chavanet P, Blettery B.

Candida spp. colonization significance in critically ill medical patients: a prospective study. Intensive Care Med 2005; 31: 393-400.

Charles PE, Tinel C, Barbar S, Aho S, Prin S, Doise J, Olsson N, Blettery B, Quenot J.

Procalcitonin kinetics within the first days of sepsis: relationship with the appropriateness of antibiotic therapy and the outcome. Crit Care 2009; 13: R38.

Chastre J, Luyt C, Trouillet J, Combes A. New diagnostic and prognostic markers of ventilator-associated pneumonia. Curr Opin Crit Care 2006; 12: 446-451.

Chastre J, Wolff M, Fagon J, Chevret S, Thomas F, Wermert D, Clementi E,

Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 2003; 290: 2588-2598.

Chiesa C, Pacifico L, Rossi N, Panero A, Matrunola M, Mancuso G. Procalcitonin as a marker of nosocomial infections in the neonatal intensive care unit. Intensive Care Med 2000; 26 Suppl 2: 175-177.

Chiesa C, Panero A, Rossi N, Stegagno M, De Giusti M, Osborn JF, Pacifico L.

Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis 1998; 26: 664-672.

Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, Muller B. Effect of procalcitonin-guided treatment on antibiotic use and

outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004; 363: 600-607.

Christ-Crain M, Muller B. Procalcitonin in bacterial infections--hype, hope, more or less? Swiss Med Wkly 2005; 135: 451-460.

Christ-Crain M, Stolz D, Bingisser R, Muller C, Miedinger D, Huber PR, Zimmerli W, Harbarth S, Tamm M, Muller B. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med 2006; 174: 84-93.

Cunha B. Antibiotic essentials. Royal Oak: Physicians press, 2007.

Dandona P, Nix D, Wilson MF, Aljada A, Love J, Assicot M, Bohuon C.

Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab 1994; 79: 1605-1608.

Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2005; CD003543.

Davis TM, Assicot M, Bohuon C, St John A, Li GQ, Anh TK. Serum procalcitonin concentrations in acute malaria. Trans R Soc Trop Med Hyg 1994; 88: 670-671.

Dornbusch HJ, Strenger V, Kerbl R, Lackner H, Schwinger W, Sovinz P, Urban C.

Procalcitonin--a marker of invasive fungal infection? Support Care Cancer 2005;

13: 343-346.

Engel C, Brunkhorst FM, Bone H, Brunkhorst R, Gerlach H, Grond S, Gruendling M, Huhle G, Jaschinski U, John S, Mayer K, Oppert M, Olthoff D, Quintel M, Ragaller M, Rossaint R, Stuber F, Weiler N, Welte T, Bogatsch H, Hartog C, Loeffler M, Reinhart K. Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 2007; 33: 606-618.

Erickson SE, Martin GS. Effect of sepsis therapies on health-related quality of life.

Crit Care 2008; 12: 109.

Geldner G, Ruoff M, Hoffmann HJ, Kiefer P, Georgieff M, Wiedeck H. Cost analysis concerning MRSA-infection in ICU. Anasthesiol Intensivmed Notfallmed

Schmerzther 1999; 34: 409-413.

Gendrel D, Assicot M, Raymond J, Moulin F, Francoual C, Badoual J, Bohuon C.

Procalcitonin as a marker for the early diagnosis of neonatal infection. J Pediatr 1996; 128: 570-573.

Gendrel D, Raymond J, Assicot M, Moulin F, Iniguez JL, Lebon P, Bohuon C.

Measurement of procalcitonin levels in children with bacterial or viral meningitis. Clin Infect Dis 1997; 24: 1240-1242.

Georges B, Cougot P, Decun JF, Mazerolles M, Andrieu P, Samii K, Virenque C.

Duration of antibiotic treatment in intensive care: current data. Ann Fr Anesth Reanim 2000; 19: 367-374.

Gleisner ALM, Argenta R, Pimentel M, Simon TK, Jungblut CF, Petteffi L, de Souza RM, Sauerssig M, Kruel CDP, Machado ARL. Infective complications according to duration of antibiotic treatment in acute abdomen. Int J Infect Dis 2004; 8: 155-162.

Harbarth S. The effect of antimicrobial use on emergence and selection of

resistance. Anasthesiol Intensivmed Notfallmed Schmerzther 2007; 42: 130-135.

Harbarth S, Holeckova K, Froidevaux C, Pittet D, Ricou B, Grau GE, Vadas L, Pugin J. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med 2001; 164: 396-402.

Hedrick TL, Evans HL, Smith RL, McElearney ST, Schulman AS, Chong TW, Pruett TL, Sawyer RG. Can we define the ideal duration of antibiotic therapy? Surg Infect (Larchmt) 2006; 7: 419-432.

Ivancević N, Radenković D, Bumbasirević V, Karamarković A, Jeremić V, Kalezić N, Vodnik T, Beleslin B, Milić N, Gregorić P, Zarković M. Procalcitonin in preoperative diagnosis of abdominal sepsis. Langenbecks Arch Surg 2008;

393: 397-403.

Jensen JU, Heslet L, Jensen TH, Espersen K, Steffensen P, Tvede M. Procalcitonin increase in early identification of critically ill patients at high risk of mortality.

Crit Care Med 2006; 34: 2596-2602.

Jensen JU, Lundgren B, Lundgren JD. Meta-analysis of procalcitonin for sepsis detection. Lancet Infect Dis 2007; 7: 499-500; author reply 502-503.

Jones A, Fiechtl J, Brown M, Ballew J, Kline J. Procalcitonin test in the diagnosis of bacteremia: a meta-analysis. Ann Emerg Med 2006; 50: 34-41

Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006; 34: 1589-1596.

Le Gall JR, Lemeshow S, Saulnier F. A New Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993;

270: 2957-2963.

Lehmann LE, Hunfeld K, Emrich T, Haberhausen G, Wissing H, Hoeft A, Stüber F.

A multiplex real-time PCR assay for rapid detection and differentiation of 25 bacterial and fungal pathogens from whole blood samples. Med Microbiol Immunol 2008; 197: 313-324.

Lemeshow S, Le Gall JR. Modeling the severity of illness of ICU patients. A systems update. JAMA 1994; 272: 1049-1055.

Levy M, 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med 2003; 29: 530–538

Levy SB. Microbial resistance to antibiotics. an evolving and persistent problem.

Lancet 1982; 2: 83-88.

Marchetti O, Bille J, Fluckiger U, Eggimann P, Ruef C, Garbino J, Calandra T, Glauser M, Tauber MG, Pittet D. Epidemiology of candidemia in swiss tertiary care hospitals: secular trends, 1991-2000. Clin Infect Dis 2004; 38: 311-320.

Martin J, Neurohr C, Bauer M, Weiß M, Schleppers A. Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix. Anaesthesist 2008; 57: 505-512.

Meisner M. Procalcitonin (PCT). Georg Thieme Verlag, 2000.

Meisner M. Biomarkers of sepsis: clinically useful? Curr Opin Crit Care 2005;

11: 473-480.

Meisner M, Muller V, Khakpour Z, Toegel E, Redl H. Induction of procalcitonin and proinflammatory cytokines in an anhepatic baboon endotoxin shock model.

Shock 2003; 19: 187-190.

Meyer E, Buttler J, Schneider C, Strehl E, Schroeren-Boersch B, Gastmeier P, Ruden H, Zentner J, Daschner FD, Schwab F. Modified guidelines impact on antibiotic use and costs: duration of treatment for pneumonia in a neurosurgical ICU is reduced. J Antimicrob Chemother 2007; 59: 1148-1154.

Meyer E, Jonas D, Schwab F, Gastmeier P, Ruden H, Daschner FD. SARI:

Surveillance of antibiotic use and bacterial resistance in German intensive care units. Correlation between antibiotic use and the emergence of resistance.

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2004;

47: 345-351.

Mok JM, Pekmezci M, Piper SL, Boyd E, Berven SH, Burch S, Deviren V, Tay B, Hu SS. Use of C-reactive protein after spinal surgery: Comparison with erythrocyte sedimentation rate as predictor of early postoperative infectious complications.

Spine 2008; 33: 415-421.

Mokart D, Merlin M, Sannini A, Brun JP, Delpero JR, Houvenaeghel G, Moutardier V, Blache JL. Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): Early markers of postoperative sepsis after major surgery. Br J Anaesth 2005; 94: 767-773.

Molter GP, Soltesz S, Kottke R, Wilhelm W, Biedler A, Silomon M. Procalcitonin plasma concentrations and systemic inflammatory response following different types of surgery. Anaesthesist 2003; 52: 210-217.

Morgenthaler NG, Struck J, Chancerelle Y, Weglohner W, Agay D, Bohuon C, Suarez-Domenech V, Bergmann A, Muller B. Production of procalcitonin (PCT) in non-thyroidal tissue after LPS injection. Horm Metab Res 2003; 35: 290-295.

Muller B, Becker KL. Procalcitonin: How a hormone became a marker and mediator of sepsis. Swiss Med Wkly 2001; 131: 595-602.

Müller B, Christ-Crain M, Schuetz P. Meta-analysis of procalcitonin for sepsis detection. Lancet Infect Dis 2007; 7: 498-9; author reply 502-503.

Müller B, Schuetz P, Trampuz A. Circulating biomarkers as surrogates for bloodstream infections. Int J Antimicrob Agents 2007; 30 Suppl 1: 16-23.

Muller B, White JC, Nylen ES, Snider RH, Becker KL, Habener JF. Ubiquitous

expression of the calcitonin-i gene in multiple tissues in response to sepsis. J Clin Endocrinol Metab 2001; 86: 396-404.

Mussap M, Degrandi R, Cataldi L, Fanos V, Plebani M. Biochemical markers for the early assessment of neonatal sepsis: the role of procalcitonin. J Chemother 2007;

19 Suppl 2: 35-38.

Nathens AB, Rotstein OD, Marshall JC. Tertiary peritonitis: clinical features of a complex nosocomial infection. World J Surg 1998; 22: 158-163.

Nobre V, Harbarth S, Graf J, Rohner P, Pugin J. Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial. Am J Respir Crit Care Med 2008; 177: 498-505.

Nylen ES, O'Neill W, Jordan MH, Snider RH, Moore CF, Lewis M, Silva OL, Becker KL. Serum procalcitonin as an index of inhalation injury in burns. Horm Metab Res 1992; 24: 439-443.

Nylen ES, Whang KT, Snider RHJ, Steinwald PM, White JC, Becker KL. Mortality is increased by procalcitonin and decreased by an antiserum reactive to

procalcitonin in experimental sepsis. Crit Care Med 1998; 26: 1001-1006.

Oberhofer D, Rumenjak V, Lazic J, Vucic N. Inflammatory indicators in patients after surgery of the large intestine. Acta Med Croatica 2006; 60: 429-433.

Oberhoffer M, Stonans I, Russwurm S, Stonane E, Vogelsang H, Junker U, Jager L, Reinhart K. Procalcitonin expression in human peripheral blood mononuclear cells and its modulation by lipopolysaccharides and sepsis-related cytokines in vitro. J Lab Clin Med 1999; 134: 49-55.

Pastor Peidró JA, González de Dios J, Urán Moreno MM, García Avilés B, de la Morena Campillo A, Moya Benavent M. Usefulness of procalcitonin as an early diagnostic test of neonatal sepsis in newborns with risk factors for infection. An Pediatr (Barc) 2007; 67: 530-535.

Peters RPH, van Agtmael MA, Danner SA, Savelkoul PHM, Vandenbroucke-Grauls CMJE. New developments in the diagnosis of bloodstream infections. Lancet Infect Dis 2004; 4: 751-760.

Rau B, Kruger CM, Schilling MK. Procalcitonin: Improved biochemical severity stratification and postoperative monitoring in severe abdominal inflammation and sepsis. Langenbecks Arch Surg 2004; 389: 134-144.

Rau B, Steinbach G, Baumgart K, Gansauge F, Grünert A, Beger HG. The clinical value of procalcitonin in the prediction of infected necrosis in acute pancreatitis.

Intensive Care Med 2000; 26 Suppl 2: 159-164.

Rau B, Steinbach G, Gansauge F, Mayer JM, Grunert A, Beger HG. The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis. Gut 1997; 41: 832-840.

Reinhart K, Brunkhorst F, Bone H, Gerlach H, Gründling M, Kreymann G, Kujath P, Marggraf G, Mayer K, Meier-Hellmann A, Peckelsen C, Putensen C, Quintel M, Ragaller M, Rossaint R, Stüber F, Weiler N, Welte T, Werdan K. Diagnosis and therapy of sepsis: Guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine. Anaesthesist 2006; 55 Suppl 1: 43-56.

Reinhart K, Brunkhorst FM. Meta-analysis of procalcitonin for sepsis detection.

Lancet Infect Dis 2007; 7: 500-502; author reply 502-503.

Reinhart WH. Erythrocyte sedimentation rate--more than an old fashion? Ther Umsch 2006; 63: 108-112.

Rothenburger M, Markewitz A, Lenz T, Kaulbach HG, Marohl K, Kuhlmann WD, Weinhold C. Detection of acute phase response and infection. The role of procalcitonin and C-reactive protein. Clin Chem Lab Med 1999; 37: 275-279.

Ruhnke M. Epidemiology of candida albicans infections and role of non-candida-albicans yeasts. Curr Drug Targets 2006; 7: 495-504.

Schroeder S, Hochreiter M, Koehler T, Schweiger A, Bein B, Keck FS, von Spiegel T.

Procalcitonin (PCT)-guided algorithm reduces length of antibiotic treatment in surgical intensive care patients with severe sepsis: Results of a prospective randomized study. Langenbecks Arch Surg 2008; 394: 221-226.

Schuetz P, Christ-Crain M, Wolbers M, Schild U, Thomann R, Falconnier C,

Widmer I, Neidert S, Blum CA, Schönenberger R, Henzen C, Bregenzer T, Hoess C, Krause M, Bucher HC, Zimmerli W, Müller B. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: A prospective, multicenter, randomized controlled trial. BMC Health Serv Res 2007; 7: 102.

Schuster H. Intensivtherapie bei Sepsis und Multiorganversagen. Werdan K, Springer Verlag, 2000.

Selberg O, Hecker H, Martin M, Klos A, Bautsch W, Kohl J. Discrimination of sepsis and systemic inflammatory response syndrome by determination of circulating plasma concentrations of procalcitonin, protein complement 3a, and interleukin-6. Crit Care Med 2000; 28: 2793-2798.

Shafazand S, Weinacker AB. Blood cultures in the critical care unit: Improving utilization and yield. Chest 2002; 122: 1727-1736.

Sinclair D, Svendsen A, Marrie T. Bacteremia in nursing home patients. Prevalence among patients presenting to an emergency department. Can Fam Physician 1998; 44: 317-322.

Stolz D, Christ-Crain M, Bingisser R, Leuppi J, Miedinger D, Muller C, Huber P, Muller B, Tamm M. Antibiotic treatment of exacerbations of COPD: A

randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest 2007; 131: 9-19.

Swartz MN. Use of antimicrobial agents and drug resistance. N Engl J Med 1997;

337: 491-492.

Tang BMP, Eslick GD. Procalcitonin for sepsis: Methodological issues in meta-analysis lead to further uncertainty. Crit Care Med 2007; 35: 679; author reply 679-680.

Tavares E, Maldonado R, Ojeda ML, Minano FJ. Circulating inflammatory mediators during start of fever in differential diagnosis of gram-negative and gram-positive infections in leukopenic rats. Clin Diagn Lab Immunol 2005;

12: 1085-1093.

Thomas L. Labor und Diagnose 6. Auflage. Thomas L, TH-Books Verlagsgesellschaft mbH, Frankfurt, 2005.

Tugrul S, Esen F, Celebi S, Ozcan PE, Akinci O, Cakar N, Telci L. Reliability of procalcitonin as a severity marker in critically ill patients with inflammatory response. Anaesth Intensive Care 2002; 30: 747-754.

Tunca F, Senyurek YG, Terzioglu T, Tanakol R, Tezelman S. Impact of total versus subtotal thyroidectomy on calcium metabolism and bone mineral density in premenopausal women. J Laryngol Otol 2009; 123: 434-438.

Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret G. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: A systematic review and meta-analysis. Crit Care Med 2006; 34: 1996-2003.

Vandijck DM, Depaemelaere M, Labeau SO, Depuydt PO, Annemans L, Buyle FM, Oeyen S, Colpaert KE, Peleman RP, Blot SI, Decruyenaere JM. Daily cost of antimicrobial therapy in patients with intensive care unit-acquired, laboratory-confirmed bloodstream infection. Int J Antimicrob Agents 2008; 31: 161-165.

Viallon A, Guyomarc'h P, Guyomarc'h S, Tardy B, Robert F, Marjollet O, Caricajo A, Lambert C, Zeni F, Bertrand J. Decrease in serum procalcitonin levels over time during treatment of acute bacterial meningitis. Crit Care 2005; 9: R344-350.

Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: Results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med 1998; 26: 1793-1800.

Vincent JL. The SOFA (Sepsis-Related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Medicine 1996; 22: 707-710.

Volk T, Schmutzler M, Engelhardt L, Döcke WD, Volk HD, Konertz W, Kox WJ.

Influence of aminosteroid and glucocorticoid treatment on inflammation and immune function during cardiopulmonary bypass. Crit Care Med 2001;

29: 2137-2142.

von Heimburg D, Stieghorst W, Khorram-Sefat R, Pallua N. Procalcitonin--a sepsis parameter in severe burn injuries. Burns 1998; 24: 745-750.

Wagner KE, Martinez JM, Vath SD, Snider RH, Nylen ES, Becker KL, Muller B, White JC. Early immunoneutralization of calcitonin precursors attenuates the adverse physiologic response to sepsis in pigs. Crit Care Med 2002; 30: 2313-2321.

Welte T. Sepsis management -- antibiotic therapy. Dtsch Med Wochenschr 2004;

129: 2609-2613.

Welte T, Brunkhorst M. Antibiotikatherapie in der Sepsis. Ärzteblatt Thüringen 2007; 7-8: 427-433.

Wernitz MH, Keck S, Swidsinski S, Schulz S, Veit SK. Cost analysis of a hospital-wide selective screening programme for methicillin-resistant staphylococcus aureus (MRSA) carriers in the context of diagnosis related groups (DRG) payment. Clin Microbiol Infect 2005; 11: 466-471.

Whang KT, Vath SD, Becker KL, Snider RH, Nylen ES, Muller B, Li Q, Tamarkin L, White JC. Procalcitonin and proinflammatory cytokine in interactions in sepsis.

Shock 1999; 12: 268-273.

Woiciechowsky C, Schöning B, Cobanov J, Lanksch WR, Volk H, Döcke W. Early IL-6 plasma concentrations correlate with severity of brain injury and

pneumonia in brain-injured patients. J Trauma 2002; 52: 339-345.

Yu VL, Singh N. Excessive antimicrobial usage causes measurable harm to patients with suspected ventilator-associated pneumonia. Intensive Care Med 2004;

30: 735-738.