Impact of Procalcitonin Monitoring on Duration of Antibiotics inPatients With Sepsis and/or Pneumonia in a Community HospitalSetting

摘要

>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-dayreadmission. >Conclusion: PCT monitoring in patients with suspectedpneumonia and/or sepsis in the community setting failed to show a reduction induration of inpatient antibiotics after the introduction of PCT monitoring.However, PCT resulted in significantly fewer discharge antibiotics and overallinpatient plus post-discharge antibiotic duration, with no detrimental effect onmortality or readmission.