Can an algorithm for the use of procalcitonin rationalize the treatment of lower respiratory tract infection?

Abstract

Background: Based on internationally published studies on procalcitonin (PCT)-guided antibiotic therapy for community-acquired lower respiratory tract infections, we decided to test PCT as a diagnostic and guiding test for such patients admitted to our hospital. We aimed to present a PCT-algorithm as a more standardised treatment regimen and possibly reduce the use of antibiotics. Materials and methods: During a two-year period, starting January 2012, medical doctors registered 93 patients and regarded recommended antibiotic therapy before and after PCT test results were revealed. A PCT treatment-algorithm was available. Results: Additional knowledge of the corresponding PCT-value led to withdrawal of antibiotic treatment in seven patients, as opposed to theoretically 59, according to the PCT-guided algorithm. Conclusions: Our study showed a weak, non- linear correlation between CRP and PCT values. The registration forms showed that antibiotic treatment was stopped for seven patients after knowledge of the PCT value. Hence, the PCT-algorithm was scarcely used in this study. With increasing focus on reducing the use of antibiotics, we will continue to offer PCT analysis in our hospital.

Keywords

• procalcitonin
• procalcitonin-algorithm
• crp
• lower respiratory tract infection
• antibiotics