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The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza

Background: Up to 60% of the antibiotics prescribed to patients hospitalized with seasonal influenza are unnecessary. Procalcitonin (PCT) has the potential as an antimicrobial stewardship program (ASP) tool because it can differentiate between viral and bacterial etiology. We aimed to explore the ro...

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Autores principales: Christensen, Ingrid, Berild, Dag, Bjørnholt, Jørgen Vildershøj, Jelsness-Jørgensen, Lars-Petter, Debes, Sara Molvig, Haug, Jon Birger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044820/
https://www.ncbi.nlm.nih.gov/pubmed/36978440
http://dx.doi.org/10.3390/antibiotics12030573
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author Christensen, Ingrid
Berild, Dag
Bjørnholt, Jørgen Vildershøj
Jelsness-Jørgensen, Lars-Petter
Debes, Sara Molvig
Haug, Jon Birger
author_facet Christensen, Ingrid
Berild, Dag
Bjørnholt, Jørgen Vildershøj
Jelsness-Jørgensen, Lars-Petter
Debes, Sara Molvig
Haug, Jon Birger
author_sort Christensen, Ingrid
collection PubMed
description Background: Up to 60% of the antibiotics prescribed to patients hospitalized with seasonal influenza are unnecessary. Procalcitonin (PCT) has the potential as an antimicrobial stewardship program (ASP) tool because it can differentiate between viral and bacterial etiology. We aimed to explore the role of PCT as an ASP tool in hospitalized seasonal influenza patients. Methods: We prospectively included 116 adults with seasonal influenza from two influenza seasons, 2018–2020. All data was obtained from a single clinical setting and analyzed by descriptive statistics and regression models. Results: In regression analyses, we found a positive association of PCT with 30 days mortality and the amount of antibiotics used. Influenza diagnosis was associated with less antibiotic use if the PCT value was low. Patients with a low initial PCT (<0.25 µg/L) had fewer hospital and intensive care unit (ICU) days and fewer positive chest X-rays. PCT had a negative predictive value of 94% for ICU care stay, 98% for 30 days mortality, and 88% for bacterial coinfection. Conclusion: PCT can be a safe rule-out test for bacterial coinfection. Routine PCT use in seasonal influenza patients with an uncertain clinical picture, and rapid influenza PCR testing, may be efficient as ASP tools.
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spelling pubmed-100448202023-03-29 The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza Christensen, Ingrid Berild, Dag Bjørnholt, Jørgen Vildershøj Jelsness-Jørgensen, Lars-Petter Debes, Sara Molvig Haug, Jon Birger Antibiotics (Basel) Article Background: Up to 60% of the antibiotics prescribed to patients hospitalized with seasonal influenza are unnecessary. Procalcitonin (PCT) has the potential as an antimicrobial stewardship program (ASP) tool because it can differentiate between viral and bacterial etiology. We aimed to explore the role of PCT as an ASP tool in hospitalized seasonal influenza patients. Methods: We prospectively included 116 adults with seasonal influenza from two influenza seasons, 2018–2020. All data was obtained from a single clinical setting and analyzed by descriptive statistics and regression models. Results: In regression analyses, we found a positive association of PCT with 30 days mortality and the amount of antibiotics used. Influenza diagnosis was associated with less antibiotic use if the PCT value was low. Patients with a low initial PCT (<0.25 µg/L) had fewer hospital and intensive care unit (ICU) days and fewer positive chest X-rays. PCT had a negative predictive value of 94% for ICU care stay, 98% for 30 days mortality, and 88% for bacterial coinfection. Conclusion: PCT can be a safe rule-out test for bacterial coinfection. Routine PCT use in seasonal influenza patients with an uncertain clinical picture, and rapid influenza PCR testing, may be efficient as ASP tools. MDPI 2023-03-14 /pmc/articles/PMC10044820/ /pubmed/36978440 http://dx.doi.org/10.3390/antibiotics12030573 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Christensen, Ingrid
Berild, Dag
Bjørnholt, Jørgen Vildershøj
Jelsness-Jørgensen, Lars-Petter
Debes, Sara Molvig
Haug, Jon Birger
The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza
title The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza
title_full The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza
title_fullStr The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza
title_full_unstemmed The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza
title_short The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza
title_sort role of procalcitonin as an antimicrobial stewardship tool in patients hospitalized with seasonal influenza
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044820/
https://www.ncbi.nlm.nih.gov/pubmed/36978440
http://dx.doi.org/10.3390/antibiotics12030573
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