Comparison of standard care versus a biomarker algorithm to guide antibiotic stewardship in pediatric intensive care unit: a prospective observational cohort study with historical control (the BASIP study).

The approach combined procalcitonin (procalcitonin)-guided decision-making with serial clinical and microbiological assessment to reduce antibiotic duration.

Restart of intravenous antibiotics or pediatric intensive care unit readmission within 7 days occurred in 7.1% of cases.

Procalcitonin levels differed significantly between confirmed and nonconfirmed bacterial infections (p = 0.001) and were associated with decisions regarding antibiotic de-escalation or discontinuation.

C-reactive protein and pancreatic stone protein did not demonstrate statistically significant discriminatory capacity.