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- Title
Procalcitonin utilization in the real world: An observational study of antibiotic prescribing practices.
- Authors
Choi, Justin J.; Cornelius‐Schecter, Anna; Hayden, Joshua A.; Jannat‐Khah, Deanna Pereira; O'Connell, Alexander; Baduashvili, Amiran; Lee, Jennifer; McCarthy, Matthew W.
- Abstract
Objectives: This study aims to better understand and describe antibiotic prescribing practices and adherence to a procalcitonin (PCT)‐guided algorithm in patients undergoing serum PCT testing in adult hospitalized patients. Methods: We performed an observational, retrospective study of 201 randomly selected patients who are aged ≥18 years, admitted to the general medicine floors or step‐down unit between 1 January 2017 and 31 December 2017, and had serum PCT testing. Physician adherence to a PCT‐guided algorithm was assessed through chart review. Results: We found an overall adherence of 64.7%. Adherence was highest for PCT values above 0.25 ng/mL (82.8% for 0.25‐0.50 ng/mL and 83.6% for >0.50 ng/mL). Adherence was lower for PCT values less than 0.25 ng/mL (59% for <0.1 ng/mL and 38% for 0.1‐0.24 ng/mL). Serial testing was performed in 10% of patients. Conclusions: Hospital‐based providers are more likely to overrule the algorithm and either initiate or continue antibiotics when guidelines encourage discontinuing antibiotics. These findings have important implications for antimicrobial stewardship and patient care and suggest that hospital‐based providers may benefit from targeted didactics regarding the interpretation of the serum PCT assay.
- Subjects
ALGORITHMS; ANTI-infective agents; ANTIBIOTICS; CALCITONIN; DRUG utilization; DRUG prescribing; HOSPITAL wards; MEDICAL protocols; MEDICAL records; SCIENTIFIC observation; PHYSICIANS; EVIDENCE-based medicine; DECISION making in clinical medicine; PHYSICIAN practice patterns; RETROSPECTIVE studies; DESCRIPTIVE statistics; ACQUISITION of data methodology
- Publication
Journal of Evaluation in Clinical Practice, 2020, Vol 26, Issue 4, p1220
- ISSN
1356-1294
- Publication type
Article
- DOI
10.1111/jep.13299