Pharmacy Facilitated Education of Appropriate Procalcitonin Assays and Physician Response Haley Ethredge and Maura Hall John D. Archbold Memorial Hospital - Thomasville, GA
Background/Purpose: Procalcitonin (PCT) is a biomarker that can serve as a diagnostic tool to aid in the identification of bacterial infection in sepsis, pneumonia, and bacteremia. The goal of this review is to evaluate the impact of pharmacy led physician education on the utilization of PCT assays in determining appropriate patient populations and response to levels.
Methodology: All PCT assays drawn from July 11th to August 9th 2018 were collected for analysis. Inclusion criteria were patients over 18 years old with PCT assays ordered for diagnosis or clinical signs and symptoms of sepsis or pneumonia. Education was provided to the ED physicians and hospitalists about appropriate usage and response with PCT in order to maximize antimicrobial stewardship with PCT assays and to minimize inappropriate labs. After completion of education, data from December 22nd to January 20th 2019 was compared to historical baseline data to evaluate changes in number of inappropriate PCT assays drawn and response to PCT levels.
Results: Before physician education, 59.5% of PCT draws were appropriate. After physician education, 67% of PCT draws were appropriate. After education, there was not an increase in appropriate physician response to PCT levels in pneumonia or sepsis patients.
Conclusions: Pharmacist led physician education resulted in increased use of PCT assays in patients with presumed sepsis or pneumonia and increased appropriateness of PCT draws. Several patients with low PCT levels were continued on antibiotics without physician documentation. Focus will be placed on physician documentation for PCT assays to help assess utility and effectiveness. Continuous pharmacist driven provider education on response to PCT levels will be necessary to effectively use PCTs to influence antimicrobial stewardship.
Presentation Objective: Explain how pharmacy can impact Procalcitonin draws and responses to levels.
Self-Assessment: True or False: Procalcitonin assays on hemodialysis patients are clinically appropriate.
