The feasibility of procalcitonin and CPIS score to reduce inappropriate antibiotics use among severe-critically ill COVID-19 pneumonia patients: A pilot study - 28/04/22

Doi : 10.1016/j.ajic.2022.01.030

Ornnicha Sathitakorn, MD ^a, Kittiya Jantarathaneewat, PharmD ^b,^c,^d, David J. Weber, MD, MPH ^e, David K. Warren, MD, MPH ^f, Sira Nanthapisal, MD, PhD ^c,^d,^g, Sasinuch Rutjanawech, MD ^a,^c,^d, Piyaporn Apisarnthanarak, MD ^h, Anucha Apisarnthanarak, MD ^a,^c,^d,^⁎
^a Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand
^b Department of Pharmaceutical care, Faculty of Pharmacy, Thammasat University, Prathum Thani, Thailand
^c Research group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand
^d Center of Excellence in Applied Epidemiology, Thammasat University, Prathum Thani, Thailand
^e Division of Infectious Diseases, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
^f Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
^g Department of Pediatrics, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand
^h Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

^⁎Address correspondence to Anucha Apisarnthanarak, MD, Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Prathum Thani, 10120, Thailand.Division of Infectious DiseasesFaculty of MedicineThammasat UniversityPrathum Thani10120Thailand

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Highlights

•	Antibiotics have been used in COVID-19 patients without clear indication.
•	Procalcitonin and Clinical Pulmonary for Infection Score can reduce antibiotic use.
•	Such strategies can shorter total antibiotic duration and length of hospital stay.
•	Multidrug-resistant organisms and invasive fungal infections can be reduced.

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Résumé

Antibiotics have been extensively used in COVID-19 patients without a clear indication. We conducted a study to evaluate the feasibility of procalcitonin along with the “Clinical Pulmonary for Infection Score” (CPIS) as a strategy to reduce inappropriate antibiotic use. Using procalcitonin and CPIS score (PCT-CPIS) successfully reduced inappropriate antibiotics use among severe-critically ill COVID-19 pneumonia patients (45% vs 100%; P < .01). Compared to “non PCT-CPIS” group, “PCT-CPIS” group was associated with a reduction in the incidence of multidrug-resistant organisms and invasive fungal infections (18.3% vs 36.7%; P = .03), shorter antibiotic duration (2 days vs 7 days; P < .01) and length of hospital stay (10 days vs 16 days; P < .01).

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Key words : Antibiotic stewardship, Intensive care, COVID-19, Strategy, Inappropriate antibiotic use

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	Conflicts of interest: None to report.
	Funding: This study was supported by Faculty of Medicine, Thammasat University Research Fund.

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Vol 50 - N° 5

P. 581-584 - mai 2022 Retour au numéro

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The feasibility of procalcitonin and CPIS score to reduce inappropriate antibiotics use among severe-critically ill COVID-19 pneumonia patients: A pilot study - 28/04/22

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