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.check.date2020-07-19
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorO'Riordan, Frank
dc.contributor.authorShiely, Frances
dc.contributor.authorByrne, Stephen
dc.contributor.authorO'Brien, Deirdre
dc.contributor.authorPalmer, B.
dc.contributor.authorDahly, Darren L.
dc.contributor.authorO'Connor, Terence M.
dc.contributor.authorCurran, David R.
dc.contributor.authorFleming, Aoife
dc.contributor.funderStrategy for the Control of Antimicrobial Resistance in Ireland, SARIen
dc.date.accessioned2019-11-18T10:30:22Z
dc.date.available2019-11-18T10:30:22Z
dc.date.issued2019-07-19
dc.date.updated2019-11-18T10:14:13Z
dc.description.abstractBackground: 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.sponsorshipStrategy 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.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO’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/dkz313en
dc.identifier.doi10.1093/jac/dkz313en
dc.identifier.endpage3361en
dc.identifier.issn1460-2091
dc.identifier.journaltitleJournal of Antimicrobial Chemotherapyen
dc.identifier.startpage3352en
dc.identifier.urihttps://hdl.handle.net/10468/9021
dc.identifier.volume74en
dc.language.isoenen
dc.publisherOxford University Pressen
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/74/11/3352/5536342en
dc.subjectRespiratory tract infectionsen
dc.subjectAntimicrobialsen
dc.subjectPrescribing behavioren
dc.subjectProcalcitoninen
dc.titleAn investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility studyen
dc.typeArticle (peer-reviewed)en
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