Use of procalcitonin for antibiotic stewardship in patients with COVID-19: A quality improvement project in a district general hospital.

Abstract

Antibiotic stewardship during the COVID-19 pandemic is an important part of a comprehensive strategy to improve patient outcomes and reduce long-term adverse effects secondary to rising antibiotic resistance. This report describes a quality improvement project which incorporates the use of procalcitonin (PCT) testing to rationalise antibiotic prescribing in patients with suspected or confirmed COVID-19 at Chesterfield Royal Hospital. Data were collected from 118 patients with a total of 127 PCT levels checked over a period of 20 days. Each PCT level was correlated with the subsequent antibiotic outcome as well as the result of the COVID-19 PCR swab. Results indicate that antibiotics were either never started or were stopped within 48 hours in 72% of COVID-confirmed cases with a PCT less than 0.25 μg/L. Our findings suggest that procalcitonin testing, when used in combination with thorough clinical assessment, is a safe, simple and sustainable way of reducing antibiotic use in COVID-19.

• Authors: Christina Peters, Kelly Williams, Elena A Un, Louisa Little, Abeer Saad, Katherine Lendrum, Naomi Thompson, Nicholas D Weatherley, Amanda Pegden
• Journal: Clinical medicine (London, England) (Clin Med (Lond)) Vol. 21 Issue 1 Pg. e71-e76 (Jan 2021) ISSN: 1473-4893 [Electronic] England
• PMID: 33355197 (Publication Type: Journal Article)
• Copyright: © Royal College of Physicians 2021. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Procalcitonin
• RNA, Viral

Topics

• Anti-Bacterial Agents (therapeutic use)
• COVID-19 (epidemiology, virology)
• Drug Resistance, Bacterial (drug effects)
• Female
• Follow-Up Studies
• Hospitals, District
• Humans
• Male
• Middle Aged
• Pandemics
• Procalcitonin (therapeutic use)
• RNA, Viral (analysis)
• Retrospective Studies
• SARS-CoV-2 (genetics)
• COVID-19 Drug Treatment