An investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility study

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dc.contributor.author O'Riordan, Frank
dc.contributor.author Shiely, Frances
dc.contributor.author Byrne, Stephen
dc.contributor.author O'Brien, Deirdre
dc.contributor.author Palmer, B.
dc.contributor.author Dahly, Darren L.
dc.contributor.author O'Connor, Terence M.
dc.contributor.author Curran, David R.
dc.contributor.author Fleming, Aoife
dc.date.accessioned 2019-11-18T10:30:22Z
dc.date.available 2019-11-18T10:30:22Z
dc.date.issued 2019-07-19
dc.identifier.citation O’Riordan, F., Shiely, F., Byrne, S., O’Brien, D., Palmer, B., Dahly, D., O’Connor, T. M., Curran, D. and Fleming, A. (2019) 'An investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility study', Journal of Antimicrobial Chemotherapy, 74(11), pp. 3352-3361. doi: 10.1093/jac/dkz313 en
dc.identifier.volume 74 en
dc.identifier.startpage 3352 en
dc.identifier.endpage 3361 en
dc.identifier.issn 1460-2091
dc.identifier.uri http://hdl.handle.net/10468/9021
dc.identifier.doi 10.1093/jac/dkz313 en
dc.description.abstract Background: Diagnostic uncertainty and a high prevalence of viral infections present unique challenges for antimicrobial prescribing for respiratory tract infections (RTIs). Procalcitonin (PCT) has been shown to support prescribing decisions and reduce antimicrobial use safely in patients with RTIs, but recent study results have been variable. Methods: We conducted a feasibility study of the introduction of PCT testing in patients admitted to hospital with a lower RTI to determine if PCT testing is an effective and worthwhile intervention to introduce to support the existing antimicrobial stewardship (AMS) programme and safely decrease antimicrobial prescribing in patients admitted with RTIs. Results: A total of 79 patients were randomized to the intervention PCT-guided treatment group and 40 patients to the standard care respiratory control group. The addition of PCT testing led to a significant decrease in duration of antimicrobial prescriptions (mean 6.8 versus 8.9 days, P"0.012) and decreased length of hospital stay (median 7 versus 8 days, P"0.009) between the PCT and respiratory control group. PCT did not demonstrate a significant reduction in antimicrobial consumption when measured as DDDs and days of therapy. Conclusions: PCT testing had a positive effect on antimicrobial prescribing during this feasibility study. The successful implementation of PCT testing in a randomized controlled trial requires an ongoing comprehensive education programme, greater integration into the AMS programme and delivery of PCT results in a timely manner. This feasibility study has shown that a larger randomized controlled trial would be beneficial to further explore the positive aspects of these findings. en
dc.description.sponsorship Strategy for the Control of Antimicrobial Resistance in Ireland, SARI (Educational grant from the Cork & Kerry Regional Strategy for the Control of Antimicrobial Resistance in Ireland (SARI) committee) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Oxford University Press en
dc.rights © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of Antimicrobial Chemotherapy following peer review. The version of record is available online at: https://academic.oup.com/jac/article/74/11/3352/5536342 en
dc.subject Respiratory tract infections en
dc.subject Antimicrobials en
dc.subject Prescribing behavior en
dc.subject Procalcitonin en
dc.title An investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Frances Shiely, School of Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: f.shiely@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2020-07-19
dc.date.updated 2019-11-18T10:14:13Z
dc.description.version Accepted Version en
dc.internal.rssid 494022202
dc.internal.pmid 31325313
dc.contributor.funder Strategy for the Control of Antimicrobial Resistance in Ireland, SARI en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Antimicrobial Chemotherapy en
dc.internal.copyrightchecked No
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress f.shiely@ucc.ie en
dc.internal.IRISemailaddress ddahly@ucc.ie en
dc.internal.IRISemailaddress stephen.byrne@ucc.ie en
dc.internal.IRISemailaddress a.fleming@ucc.ie en


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