Llewelyn, Martin J, Grozeva, Detelina, Howard, Philip, Euden, Joanne, Gerver, Sarah M, Hope, Russell, Heginbothom, Margaret, Powell, Neil, Richman, Colin, Shaw, Dominick et al (show 5 more authors)
(2022)
Impact of introducing procalcitonin testing on antibiotic usage in acute NHS hospitals during the first wave of COVID-19 in the UK: a controlled interrupted time series analysis of organization-level data.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 77 (4).
pp. 1189-1196.
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Abstract
<h4>Background</h4>Blood biomarkers have the potential to help identify COVID-19 patients with bacterial coinfection in whom antibiotics are indicated. During the COVID-19 pandemic, procalcitonin testing was widely introduced at hospitals in the UK to guide antibiotic prescribing. We have determined the impact of this on hospital-level antibiotic consumption.<h4>Methods</h4>We conducted a retrospective, controlled interrupted time series analysis of organization-level data describing antibiotic dispensing, hospital activity and procalcitonin testing for acute hospitals/hospital trusts in England and Wales during the first wave of COVID-19 (24 February to 5 July 2020).<h4>Results</h4>In the main analysis of 105 hospitals in England, introduction of procalcitonin testing in emergency departments/acute medical admission units was associated with a statistically significant decrease in total antibiotic use of -1.08 (95% CI: -1.81 to -0.36) DDDs of antibiotic per admission per week per trust. This effect was then lost at a rate of 0.05 (95% CI: 0.02-0.08) DDDs per admission per week. Similar results were found specifically for first-line antibiotics for community-acquired pneumonia and for COVID-19 admissions rather than all admissions. Introduction of procalcitonin in the ICU setting was not associated with any significant change in antibiotic use.<h4>Conclusions</h4>At hospitals where procalcitonin testing was introduced in emergency departments/acute medical units this was associated with an initial, but unsustained, reduction in antibiotic use. Further research should establish the patient-level impact of procalcitonin testing in this population and understand its potential for clinical effectiveness.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Anti-Bacterial Agents, Retrospective Studies, Hospitals, State Medicine, Pandemics, Interrupted Time Series Analysis, United Kingdom, Procalcitonin, COVID-19, COVID-19 Drug Treatment |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 20 Apr 2022 10:22 |
| Last Modified: | 08 Feb 2023 13:10 |
| DOI: | 10.1093/jac/dkac017 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3153437 |
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