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Observational Study
. 2023 Sep;164(3):596-605.
doi: 10.1016/j.chest.2023.04.032. Epub 2023 Apr 26.

Procalcitonin-Guided Antibiotic Prescription in Patients With COVID-19: A Multicenter Observational Cohort Study

Lisa M Hessels  1 , Esther Speksnijder  2 , Nienke Paternotte  3 , Astrid van Huisstede  3 , Willemien Thijs  3 , Margot Scheer  4 , Mariëlle van der Steen-Dieperink  4 , Lieve Knarren  5 , Joop P van Den Bergh  5 , Kristien Winckers  6 , Ronald Henry  6 , Suat Simsek  2 , Wim G Boersma  3 ; COVIDPredict Study Group
Collaborators, Affiliations
Observational Study

Procalcitonin-Guided Antibiotic Prescription in Patients With COVID-19: A Multicenter Observational Cohort Study

Lisa M Hessels et al. Chest. 2023 Sep.

Abstract

Background: Despite the low rate of bacterial coinfection, antibiotics are very commonly prescribed in hospitalized patients with COVID-19.

Research question: Does the use of a procalcitonin (PCT)-guided antibiotic protocol safely reduce the use of antibiotics in patients with a COVID-19 infection?

Study design and methods: In this multicenter cohort, three groups of patients with COVID-19 were compared in terms of antibiotic consumption, namely one group treated based on a PCT-algorithm in one hospital (n = 216) and two control groups, consisting of patients from the same hospital (n = 57) and of patients from three similar hospitals (n = 486) without PCT measurements during the same period. The primary end point was antibiotic prescription in the first week of admission.

Results: Antibiotic prescription during the first 7 days was 26.8% in the PCT group, 43.9% in the non-PCT group in the same hospital, and 44.7% in the non-PCT group in other hospitals. Patients in the PCT group had lower odds of receiving antibiotics in the first 7 days of admission (OR, 0.33; 95% CI, 0.16-0.66 compared with the same hospital; OR, 0.42; 95% CI, 0.28-0.62 compared with the other hospitals). The proportion of patients receiving antibiotic prescription during the total admission was 35.2%, 43.9%, and 54.5%, respectively. The PCT group had lower odds of receiving antibiotics during the total admission only when compared with the other hospitals (OR, 0.23; 95% CI, 0.08-0.63). There were no significant differences in other secondary end points, except for readmission in the PCT group vs the other hospitals group.

Interpretation: PCT-guided antibiotic prescription reduces antibiotic prescription rates in hospitalized patients with COVID-19, without major safety concerns.

Keywords: COVID-19; bacterial infection; biomarkers; pneumonia; procalcitonin.

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Figure 1
Figure 1
Proportion (%) of patients receiving antibiotic prescriptions during the first 7 d of admission and during total admission according to study group. PCT = procalcitonin.
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References

    1. Aggarwal S., Garcia-Telles N., Aggarwal G., et al. Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): early report from the United States. Diagnosis (Berl) 2020;7(2):91–96. - PubMed
    1. Yang W., Cao Q., Qin L., et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020;80(4):388–393. - PMC - PubMed
    1. Lippi G., Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131–1134. - PubMed
    1. Henry B.M., De Oliveira M.S., Benoit S., et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021–1028. - PubMed
    1. Langford B.J., So M., Raybardhan S., et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020;26(12):1622–1629. - PMC - PubMed

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