Please select the eligibility criteria that correspond to the clinical trial below.
Title: Procalcitonin-Guided Antimicrobial Discontinuation Strategy in Critically Ill Patients With Suspected or Confirmed Bacterial Sepsis
Brief Summary: The current study aims to validate the diagnostic use of PCT assessing its capability to individualize and shorten the duration of antibiotic therapy in critically ill patients with suspected or confirmed sepsis.

In particular, no well-designed intervention study has properly examined the following hypothesis: A PCT-guided antibiotic discontinuation strategy enables to reduce antibiotic treatment duration in critically ill patients with suspected or documented sepsis, without harming patient safety.


Options:
A: Inclusion Criteria:

* age \> 17 years
* patients in intensive care unit
* signed informed consent
* suspected or confirmed severe sepsis or septic shock

Exclusion Criteria:

* Infections caused by Listeria spp, Legionella pneumophilia, Mycobacterium tuberculosis
* Bacteremia due S. aureus
* Infections requiring prolonged therapies, such as endocarditis, cerebral abscess, chronic osteomyelitis
* Suspected or confirmed infection caused by virus, parasites
* Infections caused by P. aeruginosa ou A. baumannii
* Severe immunosuppression (ex: AIDS, post bone-marrow transplant,cystic fibrosis)
* Traumatism latest five days
* Surgery latest 5 days
* Carcinoid tumor, lung cancer, medullary thyroid cancer
B: Inclusion Criteria:

* Patient hospitalised in the ICU
* Bacterial infection suspected
* At ICU admission the patient do not receive antibiotics or receive antibiotics for less than 24hours and an interval between admission and inclusion \< 12 hours
* During ICU stay, provided that the interval between the start of suspected infection and inclusion is \< 12hours
* Written inform consent from the patient or relatives. The consent may be obtained after the enrollment if the patient is not able to give consent and if there is no relatives

Exclusion Criteria:

* Age \< 18 years
* Pregnancy
* Patient expected to remain hospitalised in the ICU for less than 3 days
* Neutropenia
* Infection or presumed infection requiring prolonged antibiotic therapy (endocarditis,osteo-articular infection, mediastinitis, deep abscess, tuberculosis, pneumocystis pneumonia, toxoplasmosis).
* Simplified Acute Physiology Score II at ICU admission (calculated during the first 12h)
* Attending physician declining to use full life support.
C: Inclusion Criteria:

1. Patients with clinically suspected or microbiologically confirmed bacterial sepsis
2. Informed consent

Exclusion Criteria:

1. Patients with microbiologically documented infections caused by the following microorganisms: Listeria spp, Legionella pneumophilia, Mycobacterium tuberculosis, Staphylococcus aureus
2. Patients with fungal infections
3. Patients with severe infections due to viruses or parasites (e.g. hemorrhagic fever, malaria)
4. Patients with suspected or confirmed bacterial meningitis or endocarditis
5. Patients with localized, deep-seated abscesses (e.g. brain abscess) without systemic sepsis
6. Patients with chronic, localized infections (e.g. chronic osteomyelitis) without systemic sepsis
7. Neutropenic and other severely immuno-compromised patients (patients infected with human immunodeficiency virus and a CD4 count \< 200; patients on immuno-suppressive therapy after solid organ transplantation; patients with cystic fibrosis)
8. Withholding of life-support
9. Early discharge or death (\< 24 hours after admission)
10. Complete absence of antimicrobial treatment despite suspicion of sepsis
D: Inclusion Criteria:

* General medical practices in NHS Fife and NHS Tayside with a compatible clinical IT system and agreeing to participate.
* Practices that agree to have relevant medication related data to be automatically extracted from their electronic clinical information systems from 1/10/10 to 30/9/13 (ie 12 months before first practice starts till 12 months after last practice starts).

Exclusion Criteria:

* Practices that use General Practice Administration System for Scotland (GPASS) or Egton Medicine Information System (EMIS) on the date of randomisation, since data extraction for the informatics requires Vision practice IT system.

Answer: C