Comparison of procalcitonin testing to a targeted audit-and-feedback strategy on prescribed durations of therapy for community-acquired pneumonia

Abstract

The procalcitonin (PCT) assay is FDA-approved to help guide antimicrobial treatment, however, conflicting data exist regarding its impact on durations of therapy. The purpose of this study was to compare the impact of PCT to a targeted audit-and-feedback (TAF) strategy on antibiotic durations of therapy for community-acquired pneumonia (CAP). A retrospective cohort study was conducted at two community teaching hospitals, one implementing PCT with routine audit-and-feedback and one implementing TAF recommending 5 days of therapy for uncomplicated CAP. Three hundred eleven patients with antibiotics ordered having an indication of pneumonia were included (Pre-TAF n = 80, Pre-PCT n = 80, Post-TAF n = 80, Post-PCT n = 71). Average duration of therapy was similar at baseline (Pre-TAF = 7.0 days vs Pre-PCT = 7.8 days, p = 0.1) and post-intervention (Post-TAF = 5.5 days vs Post-PCT = 5.4 days, p = 0.8) between groups. PCT and TAF were equally effective antimicrobial stewardship strategies in reducing total days of antibiotic therapy prescribed for CAP with no differences observed in patient outcomes.

Keywords: Anti-bacterial agents; Antimicrobial stewardship; Pneumonia; Procalcitonin.