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Use of procalcitonin during the first wave of covid-19 in the acute nhs hospitals: a retrospective observational study

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posted on 2023-06-10, 01:18 authored by Neil Powell, Philip Howard, Martin LlewelynMartin Llewelyn, Tamas Szakmany, Mahableswhar Albur, Stuart E Bond, Joanne Euden, Lucy Brookes-Howell, Paul Dark, Thomas P Hellyer, Susan Hopkins, Iain J McCullagh, Margaret Ogden, Philip Pallmann, Helena Parsons, David G Partridge, Dominick E Shaw, Bethany Shinkins, Stacy Todd, Emma Thomas-Jones, Robert West, Enitan D Carrol, Jonathan A T Sandoe
A minority of patients presenting to hospital with COVID-19 have bacterial co-infection. Procalcitonin testing may help identify patients for whom antibiotics should be prescribed or withheld. This study describes the use of procalcitonin in English and Welsh hospitals during the first wave of the COVID-19 pandemic. A web-based survey of antimicrobial leads gathered data about the use of procalcitonin testing. Responses were received from 148/151 (98%) eligible hospitals. During the first wave of the COVID-19 pandemic, there was widespread introduction and expansion of PCT use in NHS hospitals. The number of hospitals using PCT in emergency/acute admissions rose from 17 (11%) to 74/146 (50.7%) and use in Intensive Care Units (ICU) increased from 70 (47.6%) to 124/147 (84.4%). This increase happened predominantly in March and April 2020, preceding NICE guidance. Approximately half of hospitals used PCT as a single test to guide decisions to discontinue antibiotics and half used repeated measurements. There was marked variation in the thresholds used for empiric antibiotic cessation and guidance about interpretation of values. Procalcitonin testing has been widely adopted in the NHS during the COVID-19 pandemic in an unevidenced, heterogeneous way and in conflict with relevant NICE guidance. Further research is needed urgently that assesses the impact of this change on antibiotic prescribing and patient safety.

Funding

Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients? (PEACH study); G3365; NATIONAL INSTITUTE FOR HEALTH RESEARCH; RG.MOGA.122851

History

Publication status

  • Published

File Version

  • Published version

Journal

Antibiotics

ISSN

2079-6382

Publisher

MDPI

Issue

5

Volume

10

Page range

1-8

Article number

a516

Event location

Switzerland

Department affiliated with

  • Global Health and Infection Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2021-10-05

First Open Access (FOA) Date

2021-10-05

First Compliant Deposit (FCD) Date

2021-10-05

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