Llewelyn, MJ, Grozeva, D, Howard, P, Euden, J, Gerver, SM, Hope, R, Heginbothom, M, Powell, N, Richman, C, Shaw, D 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.
ISSN 0305-7453, 1460-2091
|
Text
PEACH JAC-Proof.pdf - Author Accepted Manuscript Download (1MB) | Preview |
Abstract
Background: 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. Methods: 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). Results: 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. Conclusions: 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 & Life Sciences Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 20 Apr 2022 10:22 |
| Last Modified: | 01 Mar 2026 11:43 |
| DOI: | 10.1093/jac/dkac017 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3153437 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
Altmetric
Altmetric