Impact of Procalcitonin Monitoring on Duration of Antimicrobial Therapy in ICU Patients with Pneumonia and Sepsis Richelle Chambliss, Lan Bui St. Vincent's Hospital - Birmingham, AL
Background/Purpose: Monitoring of serum procalcitonin (PCT) levels may be an effective antimicrobial stewardship strategy to guide antibiotic therapy in bacterial infections, specifically lower respiratory tract infections and sepsis. The objective of this study is to evaluate the impact of a procalcitonin monitoring algorithm on antibiotic therapy duration in intensive care unit (ICU) patients with pneumonia and/or sepsis.
Methodology: This pre-post interventional study was approved by the institutional review board. Patients 18 years or older, admitted to one of the two medical ICUs at a community hospital, who received their first dose of antibiotics within 24 hours of admission, and had a diagnosis of presumed sepsis and/or pneumonia were included. Patients were excluded if they had thyroid carcinoma, antibiotic therapy initiation greater than 48 hours prior to ICU admission, positive blood cultures, conditions requiring prolonged therapy, resuscitated cardiac arrest, or severe immunodeficiency (other than corticosteroids). Pre-intervention period was from January 2018 to March 2018; post-intervention period was January 2019 to March 2019. On-site PCT testing was not available during the pre-intervention period. PCT levels were ordered and monitored according to an approved Pharmacy and Therapeutics protocol in the post-intervention period. A clinical pharmacist screened for eligible patients, monitored the PCT level daily, and made suggestions to the medical team to discontinue antibiotic therapy if the PCT level was
