To explore the efficacy and safety of procalcitonin (PCT) in shortening the course of antimicrobial agents in cardiac surgery so as to provide references for the rational use of antimicrobial agents in the clinical practice.

A randomized controlled trial (RCT) was designed and 120 patients were included in this study. The patients were randomly divided into an experimental group (the PCT monitoring group) and a control group (the routine monitoring group) by the random number method. In the experimental group, PCT was employed to guide the use of antimicrobial agents; while in the control group, routine methods were employed to guide the use of antimicrobial agents. The consumption time of antibacterial agents, the hospitalization time, the costs for antibacterial drugs, the total hospitalization costs, and the incidence of pulmonary infection were compared between the two groups.

The antimicrobial agents were used in both the experimental group and the control group after operation. The levels of white blood cells, neutrophils and PCT decreased gradually on the 1 st, 3 rd and 7 th days. The PCT decreased to the normal level on the 3 rd day, while the percentage of neutrophils recovered to normal on the 7 th day. There was no significant difference in white blood cells, neutrophil percentages and PCT levels between the two groups at all the time points (P>0.05). However, statistical differences were found in the consumption time of antibacterial drugs, the costs for antibacterial drugs, the hospitalization time, and the hospitalization costs between the two groups. The consumption time of antibacterial drugs in the control group was 12 days, while it was 9 days in the experimental group, with a statistical significant difference between the two groups (P<0.05). The hospitalization time in the control group was 19 days, while it was 18 days in the experimental group, with a statistical significant difference between the two groups (P<0.05). The cost of the antibacterial drugs in the control group was 1, 450 yuan, while it was 1, 160 yuan in the experimental group, with a statistical significant difference between the two groups (P<0.05). The hospitalization cost in the control group was 127, 100 yuan, while it was 111, 000 yuan in the experimental group, with a statistical significant difference between the two groups (P<0.05). Two patients in the experimental group and two patients in the control group developed pulmonary infection, with no significant difference between the two groups (P>0.05).

For cardiac surgery, the prophylactic use of antibiotics guided by PCT monitoring can shorten the course of antibiotics, reduce the length of hospital stay, and save the costs of antibiotics and hospitalization. Furthermore, it does not increase the incidence of pulmonary infection.