Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia
| Autor: | Matthew A. Moffa, Derek N. Bremmer, Jim Kuzyck, Kurt Hu, Daniel Speredelozzi, Thomas L. Walsh, Briana DiSilvio, Tamara L. Trienski, Moeezullah Beg, Rikinder Sandhu, Crystal Hammer, Swati Vishwanathan, Jina Makadia, Terrence J. Obringer, Mouhib Naddour, Rasha Abdulmassih, Noreen H. Chan-Tompkins, Courtney Watson |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty 030106 microbiology Clinical Decision-Making Pneumonia Viral Controlled studies Patient Readmission Procalcitonin Drug Administration Schedule 03 medical and health sciences Antimicrobial Stewardship 0302 clinical medicine Community-acquired pneumonia Internal medicine Pneumonia Bacterial Medicine Antimicrobial stewardship Humans 030212 general & internal medicine Antibiotic use Intensive care medicine Hospitals Teaching Aged Retrospective Studies Aged 80 and over Cross Infection business.industry Retrospective cohort study General Medicine Length of Stay Middle Aged Pennsylvania medicine.disease Anti-Bacterial Agents Community-Acquired Infections Hospitalization Pneumonia Female business Educational program Algorithms Biomarkers |
| Zdroj: | The American journal of medicine. 131(2) |
| ISSN: | 1555-7162 |
| Popis: | Community-acquired pneumonia and healthcare-associated pneumonia are often treated with prolonged antibiotic therapy. Procalcitonin (PCT) has effectively and safely reduced antibiotic use for pneumonia in controlled studies. However, limited data exist regarding PCT guidance in real-world settings for management of pneumonia.A retrospective, preintervention/postintervention study was conducted to compare management for patients admitted with pneumonia before and after implementation of PCT guidance at 2 teaching hospitals in Pittsburgh, Pennsylvania. The preintervention period was March 1, 2014 through October 31, 2014, and the postintervention period was March, 1 2015 through October 31, 2015.A total of 152 and 232 patients were included in the preintervention and postintervention cohorts, respectively. When compared with the preintervention group, mean duration of therapy decreased (9.9 vs 6.0 days; P .001). More patients received an appropriate duration of 7 days or less (26.9% vs 66.4%; P .001). Additionally, mean hospital length of stay decreased in the postintervention group (4.9 vs 3.5 days; P = .006). Pneumonia-related 30-day readmission rates (7.2% vs 4.3%; P = .26) were unaffected. In the postintervention group, patients with PCT levels 0.25 µg/L received shorter mean duration of therapy compared with patients with levels 0.25 µg/L (4.6 vs 8.0 days; P .001), as well as reduced hospital length of stay (3.2 vs 3.9 days; P = .02).In this real-world study, PCT guidance led to shorter durations of total antibiotic therapy and abridged inpatient length of stay without affecting hospital readmissions. |
| Databáze: | OpenAIRE |
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