Abstract：Objective To systematically review the effectiveness, safety, and economics of procalcitonin in the use of antibiotics in children with respiratory tract infections. Methods Databases including PubMed, EMBase, The Cochrane Library (Issue 3, 2018), CBM, CNKI, VIP, and Wan Fang Data were searched to collect randomized controlled trials (RCTs) about the effectiveness, safety, and economics of procalcitonin in the use of antibiotics in children with respiratory tract infections till March 2018. Two reviewers independently screened literatures, extracted data, and assessed the quality of included studies. Then Meta-analysis was conducted by the RevMan 5.3 software. Results A total of eight studies involving 1,601 patients were included. The results of Meta-analysis showed that in terms of effectiveness, the use of procalcitonin in the treatment of antibiotics in children with respiratory tract infections could significantly improve the efficacy of post-treatment patients compared with the routine use of antibiotics [RR=1.10, 95%CI(1.04, 1.16), P=0.001], reduce cough time [MD=-0.46, 95%CI(-0.78, -0.14), P=0.004], antibiotic use time [MD=-2.28, 95%CI(-2.59, -1.97), P＜0.00001], hospital stay [MD=-2.12, 95%CI(-3.13, -1.11), P＜0.0001], and the difference was statistically significant. In terms of safety, the difference in the incidence of adverse reactions was not statistically significant [RR=0.99, 95%CI(0.81, 1.22), P=0.96]. In terms of economy, the application of calcitonin guide can reduce antibiotic use costs[SMD=-3.39, 95%CI(-4.51, -2.26), P＜0.00001]. Conclusion Current evidence shows that the procalcitonin has a significant effect on the use of antibiotics in the treatment of respiratory tract infections in children. It can provide sustained clinical remission for children and reduce the use of antibiotics in children. Due to the limited quality of included studies, the above conclusion still needs to be verified by more high quality studies.
