Procalcitonin Assay Doesn’t Cut Antibiotic Use in Lower RTI

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Provision of assay doesn't result in less antibiotic use for suspected lower respiratory tract infection.

HealthDay News — For patients with suspected lower respiratory tract infection, the provision of procalcitonin assay results does not result in less use of antibiotics than usual care, according to a study published online May 20 in the New England Journal of Medicine to coincide with the American Thoracic Society’s 2018 International Conference, held from May 18 to 23 in San Diego.

David T. Huang, MD, MPH, from the University of Pittsburgh, and colleagues evaluated outcomes for patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated. 

Patients were randomized to either the procalcitonin group, in which the physician was provided with real-time initial procalcitonin assay results and an antibiotic use guide with graded recommendations (826 patients), or the usual care group (830 patients).

The researchers found that the treating physician received procalcitonin assay results for 95.9 and 2.2 percent of patients in the procalcitonin and usual care groups, respectively. The procalcitonin-level tier correlated with the decision to prescribe antibiotics in the emergency department in both groups. 

There was no significant between-group difference in antibiotic-days or in the proportion of patients with adverse outcomes.

“The provision of procalcitonin assay results, along with instructions on their interpretation, to emergency department and hospital-based clinicians did not result in less use of antibiotics than did usual care among patients with suspected lower respiratory tract infection,” the authors write.

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