Faculty Collaboration Database

Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia. Am J Med 2018 Feb;131(2):201.e1-201.e8

Date

09/28/2017

Pubmed ID

28947168

DOI

10.1016/j.amjmed.2017.08.039

Scopus ID

2-s2.0-85034823016 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

BACKGROUND: Community-acquired pneumonia and healthcare-associated pneumonia are often treated with prolonged antibiotic therapy. Procalcitonin (PCT) has effectively and safely reduced antibiotic use for pneumonia in controlled studies. However, limited data exist regarding PCT guidance in real-world settings for management of pneumonia.

METHODS: A retrospective, preintervention/postintervention study was conducted to compare management for patients admitted with pneumonia before and after implementation of PCT guidance at 2 teaching hospitals in Pittsburgh, Pennsylvania. The preintervention period was March 1, 2014 through October 31, 2014, and the postintervention period was March, 1 2015 through October 31, 2015.

RESULTS: A total of 152 and 232 patients were included in the preintervention and postintervention cohorts, respectively. When compared with the preintervention group, mean duration of therapy decreased (9.9 vs 6.0 days; P < .001). More patients received an appropriate duration of 7 days or less (26.9% vs 66.4%; P < .001). Additionally, mean hospital length of stay decreased in the postintervention group (4.9 vs 3.5 days; P = .006). Pneumonia-related 30-day readmission rates (7.2% vs 4.3%; P = .26) were unaffected. In the postintervention group, patients with PCT levels <0.25 µg/L received shorter mean duration of therapy compared with patients with levels >0.25 µg/L (4.6 vs 8.0 days; P < .001), as well as reduced hospital length of stay (3.2 vs 3.9 days; P = .02).

CONCLUSIONS: In this real-world study, PCT guidance led to shorter durations of total antibiotic therapy and abridged inpatient length of stay without affecting hospital readmissions.

Author List

Walsh TL, DiSilvio BE, Hammer C, Beg M, Vishwanathan S, Speredelozzi D, Moffa MA, Hu K, Abdulmassih R, Makadia JT, Sandhu R, Naddour M, Chan-Tompkins NH, Trienski TL, Watson C, Obringer TJ, Kuzyck J, Bremmer DN

Author

Kurt Hu MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Algorithms
Anti-Bacterial Agents
Antimicrobial Stewardship
Biomarkers
Clinical Decision-Making
Community-Acquired Infections
Cross Infection
Drug Administration Schedule
Female
Hospitalization
Hospitals, Teaching
Humans
Length of Stay
Male
Middle Aged
Patient Readmission
Pennsylvania
Pneumonia, Bacterial
Pneumonia, Viral
Retrospective Studies