Evaluation of procalcitonin as a contribution to antimicrobial stewardship in SARS-CoV-2 infection: a retrospective cohort study

J Hosp Infect. 2021 Apr:110:103-107. doi: 10.1016/j.jhin.2021.01.006. Epub 2021 Jan 20.

Abstract

It can be a diagnostic challenge to identify patients with coronavirus disease 2019 in whom antibiotics can be safely withheld. This study evaluated the effectiveness of a guideline implemented at Sheffield Teaching Hospitals NHS Foundation Trust that recommends withholding antibiotics in patients with low serum procalcitonin (PCT), defined as ≤0.25 ng/mL. Results showed reduced antibiotic consumption in patients with PCT ≤0.25 ng/mL with no increase in mortality, alongside a reduction in subsequent carbapenem prescriptions during admission. The results support the effectiveness of this guideline, and further research is recommended to identify the optimal cut-off value for PCT in this setting.

Keywords: Antimicrobial stewardship; Bacterial co-infection; COVID-19; Procalcitonin; SARS-CoV-2; Superadded infection.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / standards*
  • Anti-Bacterial Agents / therapeutic use*
  • Antimicrobial Stewardship / methods
  • Antiviral Agents / standards*
  • Antiviral Agents / therapeutic use*
  • Bacterial Infections / blood
  • Bacterial Infections / drug therapy*
  • Biomarkers / blood
  • COVID-19 Drug Treatment*
  • Cohort Studies
  • Coinfection / blood
  • Coinfection / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Procalcitonin / blood*
  • Retrospective Studies
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Biomarkers
  • Procalcitonin