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Case Study 2 – Resolution

Article reviewing the second case study and drawing conclusions.
© BSAC

Now you have had an opportunity to discuss this case, we will examine what happened next.

Recap – what happened?

On day 15 after surgery, the patient collapsed twice at home then was taken to a local emergency department which was not a cardiac centre. Upon admission PCT = 0.46 and CRP = 220 therefore sepsis was diagnosed. Four hours after admission, the patient collapsed again and the emergency medical team was called.

What was done?

An ambulance was called for the patient. The sepsis 6 measurement was taken alongside PCT and CRP and broad-spectrum IV antibiotics prescribed as per local antibiotic policy. IV fluids were increased and oxygen was given as the case was passed to the cardiac ward.

After admission

Pleural effusion was identified on day 3 after admission which was drained. At this time PCT=0.17 and CRP=186. CRP=128 on day 5 when broad-spectrum antibiotics continued. On day CRP=79 and IV antibiotics were converted to oral antibiotics on day 9. On day 10 CRP=38. The patient was discharged to home to complete antibiotics until day 14.

The patient was back to a fit and active lifestyle 3 months after surgery.

It’s important to keep in mind that appropriate clinical judgement must be made for each patient, and there will never be a ‘one size fits all’ approach.

© BSAC
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Procalcitonin: PCT as a Biomarker for Antimicrobial Stewardship

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