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Use of procalcitonin during the first wave of covid-19 in the acute nhs hospitals: A retrospective observational study

Lookup NU author(s): Dr Tom Hellyer, Dr Iain McCullagh

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2021 by the authors. Licensee MDPI, Basel, Switzerland.A minority of patients presenting to hospital with COVID-19 have bacterial co-infection. Procalcitonin testing may help identify patients for whom antibiotics should be prescribed or withheld. This study describes the use of procalcitonin in English and Welsh hospitals during the first wave of the COVID-19 pandemic. A web-based survey of antimicrobial leads gathered data about the use of procalcitonin testing. Responses were received from 148/151 (98%) eligible hospitals. During the first wave of the COVID-19 pandemic, there was widespread introduction and expansion of PCT use in NHS hospitals. The number of hospitals using PCT in emergency/acute admissions rose from 17 (11%) to 74/146 (50.7%) and use in Intensive Care Units (ICU) increased from 70 (47.6%) to 124/147 (84.4%). This increase happened predominantly in March and April 2020, preceding NICE guidance. Approximately half of hospitals used PCT as a single test to guide decisions to discontinue antibiotics and half used repeated measurements. There was marked variation in the thresholds used for empiric antibiotic cessation and guidance about interpretation of values. Procalcitonin testing has been widely adopted in the NHS during the COVID-19 pandemic in an unevidenced, heterogeneous way and in conflict with relevant NICE guidance. Further research is needed urgently that assesses the impact of this change on antibiotic prescribing and patient safety.

Publication metadata

Author(s): Powell N, Howard P, Llewelyn MJ, Szakmany T, Albur M, Bond SE, Euden J, Brookes-Howell L, Dark P, Hellyer TP, Hopkins S, McCullagh IJ, Ogden M, Pallmann P, Parsons H, Partridge DG, Shaw DE, Shinkins B, Todd S, Thomas-Jones E, West R, Carrol ED, Sandoe JAT

Publication type: Article

Publication status: Published

Journal: Antibiotics

Year: 2021

Volume: 10

Issue: 5

Online publication date: 01/05/2021

Acceptance date: 29/04/2021

Date deposited: 03/06/2021

ISSN (electronic): 2079-6382

Publisher: MDPI AG

URL: https://doi.org/10.3390/antibiotics10050516

DOI: 10.3390/antibiotics10050516

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