Impact of Procalcitonin Monitoring on Duration of Antibiotics in Patients With Sepsis and/or Pneumonia in a Community Hospital Setting.
Elizabeth W CovingtonStephen EureDoug CarrollChristen FreemanPublished in: The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians (2018)
Background: Procalcitonin (PCT) is a biomarker specific for bacterial infections versus viral or noninfectious causes. Utilizing PCT as a guide for antibiotic duration could have benefit in limiting antimicrobial overuse. Objective: The objective of this study was to analyze the effect of PCT monitoring on inpatient antibiotic duration for pneumonia and sepsis at a community hospital. Methods: This study utilized a prospective cohort design with a historical control group prior to the availability of PCT testing and a prospective intervention group after the availability of PCT testing at a community hospital. Results: A total of 102 patients (51 retrospective and 51 prospective) were included in the analysis. There was no difference in mean duration of inpatient antibiotics (6.1 ± 3.9 vs 5.4 ± 2.9 days, P = .50). Additionally, there was no difference in the average time to antibiotic de-escalation, average hospital length of stay, or intensive care unit length of stay. PCT monitoring resulted in a 41% reduction in discharge antibiotics (63% vs 37%, P = .0090) and a 2.2-day reduction in duration of overall inpatient and post-discharge antibiotics (9.5 ± 4.5 vs 7.3 ± 4.1 days, P = .013). There was no difference in mortality, relapse of infection, or 30-day readmission. Conclusion: PCT monitoring in patients with suspected pneumonia and/or sepsis in the community setting failed to show a reduction in duration of inpatient antibiotics after the introduction of PCT monitoring. However, PCT resulted in significantly fewer discharge antibiotics and overall inpatient plus post-discharge antibiotic duration, with no detrimental effect on mortality or readmission.
Keyphrases
- acute care
- mental health
- intensive care unit
- healthcare
- palliative care
- acute kidney injury
- end stage renal disease
- randomized controlled trial
- cardiovascular events
- type diabetes
- risk factors
- adverse drug
- chronic kidney disease
- ejection fraction
- staphylococcus aureus
- septic shock
- cardiovascular disease
- newly diagnosed
- emergency department
- study protocol
- open label
- respiratory failure
- data analysis