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      Use of procalcitonin for antibiotic stewardship in patients with COVID-19: A quality improvement project in a district general hospital

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          ABSTRACT

          Antibiotic stewardship during the COVID-19 pandemic is an important part of a comprehensive strategy to improve patient outcomes and reduce long-term adverse effects secondary to rising antibiotic resistance. This report describes a quality improvement project which incorporates the use of procalcitonin (PCT) testing to rationalise antibiotic prescribing in patients with suspected or confirmed COVID-19 at Chesterfield Royal Hospital. Data were collected from 118 patients with a total of 127 PCT levels checked over a period of 20 days. Each PCT level was correlated with the subsequent antibiotic outcome as well as the result of the COVID-19 PCR swab. Results indicate that antibiotics were either never started or were stopped within 48 hours in 72% of COVID-confirmed cases with a PCT less than 0.25 μg/L. Our findings suggest that procalcitonin testing, when used in combination with thorough clinical assessment, is a safe, simple and sustainable way of reducing antibiotic use in COVID-19.

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          Author and article information

          Contributors
          Role: internal medicine trainee
          Role: internal medicine trainee
          Role: internal medicine trainee
          Role: foundation year 2 doctor
          Role: respiratory medicine and general internal medicine specialty registrar
          Role: consultant in emergency medicine and emergency department clinical lead
          Role: microbiology consultant
          Role: NIHR academic clinical lecturer in respiratory medicine
          Role: sepsis lead and consultant in acute medicine
          Journal
          Clin Med (Lond)
          Clin Med (Lond)
          Clinical Medicine
          Royal College of Physicians
          1470-2118
          1473-4893
          January 2021
          : 21
          : 1
          : e71-e76
          Affiliations
          AChesterfield Royal Hospital, Chesterfield, UK
          BChesterfield Royal Hospital, Chesterfield, UK
          CChesterfield Royal Hospital, Chesterfield, UK
          DChesterfield Royal Hospital, Chesterfield, UK
          EChesterfield Royal Hospital, Chesterfield, UK
          FUniversity of Sheffield, Sheffield, UK, UK
          GChesterfield Royal Hospital, Chesterfield, UK
          Author notes
          Address for correspondence: Dr Amanda Pegden, Chesterfield Royal Hospital, Chesterfield Road, Calow, Chesterfield S44 5BL, UK. Email: amanda.pegden1@ 123456nhs.net
          Article
          PMC7850181 PMC7850181 7850181 clinmedicine
          10.7861/clinmed.2020-0614
          7850181
          33355197
          f38baeb4-fec1-4d3a-a8d1-95dc254828d3
          © Royal College of Physicians 2021. All rights reserved.
          History
          Page count
          Figures: 3, Tables: 3, Equations: 0, References: 14, Pages: 6
          Categories
          COVID-19 rapid report

          procalcitonin,COVID-19,antibiotic stewardship,bacterial resistance,quality improvement

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