Procalcitonin for reduced antibiotic exposure in the critical care setting: A systematic review and an economic evaluation*

Abstract

Procalcitonin-guided antibiotic therapy is associated with a reduction in antibiotic usage that, under certain assumptions, may reduce overall costs of care. However, the overall estimate cannot rule out a 7% increase in hospital mortality.

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

“…The use of procalcitonin [64,144,145] or similar biomarkers may facilitate discontinuance of antibiotics in a patient with clinical improvement, although one recent study failed to show any benefit of daily procalcitonin measurement [146]. Table 4) should be rapidly referred to an intensive care unit (ICU) In 2004, the "Surviving Sepsis Campaign" guidelines recommended the use of EGDT [147] based on one large randomized trial [93].…”

Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective

“…There is strong evidence that PCT-guided care management results in reductions in antibiotic exposure and possibly costs [33,35,37,38,[48][49][50][51][52][53]. For example, a comparative effectiveness summary report from the US Agency for Healthcare Research and Quality ("AHRQ"; 2012) concluded that there was high strength of evidence in support of PCT reducing antibiotic usage, with relative reductions ranging from 21% to 38% [53].…”

“…Based on published randomized trials of PCT-guided treatment in Canadian hospital intensive care units, Heyland et al conducted a cost-minimization analysis based on the costs of PCT testing and antibiotic acquisition and administration [51]. PCT-guided strategies were associated with a significant reduction in antibiotic use, and PCT-guided care was not associated with any differences in hospital mortality.…”

“…PCT has the potential to improve the management of health care resources a number of ways, including: 1) reducing unnecessary antibiotic prescriptions and supporting improved antibiotic stewardship; 2) reducing hospital LOS; 3) improving the timing of diagnosis and treatment; and 4) improving the ability of clinicians to optimally match diagnosis and treatment [5,34,51,[54][55][56][57][58][59][60].…”

Procalcitonin-guided antibiotic therapy: a potentially effective and efficient strategy

“…Despite the evidence that PCT-guided care management results in reduction of antibiotic exposure and hospital length of stay while improving the timing of diagnosis and treatment, the existing economic literature on PCT is limited and presents several limitations [9,10]. The paper by Phillip Schuetz and Colleagues, which is published in this issue of Clinical Chemistry and Laboratory Medicine, therefore, is very welcome as it adds further evidence of the substantial cost savings associated with PCT protocols of ARI in comparison to usual care [11].…”