The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza.

Autor:	Christensen I; Østfold Hospital Trust, Department of Infection Control, 1714 Kalnes, Norway.; PhD Program Medicine and Health Sciences, Faculty of Medicine, University of Oslo, 1072 Oslo, Norway., Berild D; Institute of Clinical Medicine and Department of Infectious Diseases, Oslo University Hospital, 0450 Oslo, Norway., Bjørnholt JV; Institute of Clinical Medicine, Faculty of Medicine, Oslo University, 0450 Oslo, Norway.; Department of Microbiology, Oslo University Hospital, 0372 Oslo, Norway., Jelsness-Jørgensen LP; Østfold Hospital Trust, Department of Infection Control, 1714 Kalnes, Norway.; Faculty of Health and Social Studies, Østfold University College, 1671 Fredrikstad, Norway., Debes SM; Østfold Hospital Trust, Center for Laboratory Medicine, 1714 Kalnes, Norway., Haug JB; Østfold Hospital Trust, Department of Infection Control, 1714 Kalnes, Norway.
Jazyk:	angličtina
Zdroj:	Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2023 Mar 14; Vol. 12 (3). Date of Electronic Publication: 2023 Mar 14.
DOI:	10.3390/antibiotics12030573
Abstrakt:	Background: Up to 60% of the antibiotics prescribed to patients hospitalized with seasonal influenza are unnecessary. Procalcitonin (PCT) has the potential as an antimicrobial stewardship program (ASP) tool because it can differentiate between viral and bacterial etiology. We aimed to explore the role of PCT as an ASP tool in hospitalized seasonal influenza patients. Methods: We prospectively included 116 adults with seasonal influenza from two influenza seasons, 2018-2020. All data was obtained from a single clinical setting and analyzed by descriptive statistics and regression models. Results: In regression analyses, we found a positive association of PCT with 30 days mortality and the amount of antibiotics used. Influenza diagnosis was associated with less antibiotic use if the PCT value was low. Patients with a low initial PCT (<0.25 µg/L) had fewer hospital and intensive care unit (ICU) days and fewer positive chest X-rays. PCT had a negative predictive value of 94% for ICU care stay, 98% for 30 days mortality, and 88% for bacterial coinfection. Conclusion: PCT can be a safe rule-out test for bacterial coinfection. Routine PCT use in seasonal influenza patients with an uncertain clinical picture, and rapid influenza PCR testing, may be efficient as ASP tools.
Databáze:	MEDLINE
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