ICU Management & Practice, Volume 20 - Issue 3, 2020

PCT-guided Antibiotic Stewardship in COVID-19 Patients

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PCT recognized by WHO as an aid to fight antibiotic resistance

PCT included on the Essential In Vitro Diagnostics List of the World Health Organization to aid in antibiotic stewardship. Ref-1

The challenge: Antibiotic resistance is an increasing threat to public health

Antibiotics (ABx) are a limited resource. At the current pace of injudicious use, all antibiotics will soon become ineffective. The WHO Global Action Plan on antimicrobial resistance, 2015, emphasizes that antimicrobial resistance is a crisis that must be managed with the utmost urgency. Ref-2

The emergence and spread of antibioticresistant bacteria harm individuals and societies worldwide by causing:

  • Prolonged illnesses
  • Higher health care expenditures
  • Greater risk of death

pct-antibiotic-stewardship-unnecessary-prescriptions*Centers for Disease Control and Prevention (CDC), Press Release, May 3, 2016

 

B·R·A·H·M·S PCT (Procalcitonin) supports responsible use of antibiotics to prolong their effectiveness

Surviving Sepsis Campaign:

“We suggest that procalcitonin levels can be used to ...
... support shortening the duration of antimicrobial therapy in sepsis patients ...
... support the discontinuation of empiric antibiotics in patients who initially appeared to have sepsis, but subsequently have limited clinical evidence of infection.“
Source: International Guidelines for Management of Sepsis and Septic Shock, 2016 Ref-3

pct-guidance-antibiotic-therapy

The benefits of PCT-guidance in antibiotic therapy

PCT-guidance of AB therapy has the potential to

  • Reduce initial prescription rates
  • Shorten treatment durations
  • Save overall treatment costs

 

Economic impact of PCT-guided treatment

brahms-pct-procalcitonin-abs-cost-savings




PCT-guided antibiotic stewardship protocols lead to

  • Reduced initial AB prescription rates
  • Reduced AB treatment duration
  • Reduced average length of stay (LOS)
  • Reduced AB resistance


The economic impact of PCT-guided treatment has been studied through health economic modeling in various settings:

  • Sepsis patients – ICU Ref-4
  • Acute Respiratory Infections – inpatient, ICU, outpatient Ref-5
  • COPD exacerbation – inpatient Ref-6


Treatment cost reductions ranging from 9% to 12% have been demonstrated across various countries. Ref-7

The cost of testing for PCT is more than offset by downstream cost savings



COVID-19: Readjusting Clinical Trials »»

References:

Ref-1: 2nd WHO Model List of Essential In Vitro Diagnostics (WHO/MVP/EMP/2019.05)


Ref-2: WHO Global Action Plan Antimicrobial Resistance, 2015


Ref-3: Rhodes et al., Intensive Care Med 2017; 43 (3): 304-377


Ref-4: Kip et al., J Med Econ 2015; 1-10


Ref-5: Schuetz et al., Clin Chem Lab Med 2015; 53(4): 583-592


Ref-6: Maas et al., Poster, ISPOR 18th Annual European Congress, Milan, 2015


Ref-7: Steuten, Cost effectiveness of biomarker testing in sepsis patients; ISICEM Brussels, March 15-19, 2015

 




antimicrobial resistance, antibiotic stewardship, Brahms PCT , PCT, COVID-19 PCT-guided Antibiotic Stewardship in COVID-19 Patients

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