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

Ornnicha Sathitakorn; Kittiya Jantarathaneewat; David J Weber; David K Warren; Sira Nanthapisal; Sasinuch Rutjanawech; Piyaporn Apisarnthanarak; Anucha Apisarnthanarak

doi:10.1016/j.ajic.2022.01.030

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

Am J Infect Control. 2022 May;50(5):581-584. doi: 10.1016/j.ajic.2022.01.030. Epub 2022 Feb 12.

Authors

Ornnicha Sathitakorn¹, Kittiya Jantarathaneewat², David J Weber³, David K Warren⁴, Sira Nanthapisal⁵, Sasinuch Rutjanawech⁶, Piyaporn Apisarnthanarak⁷, Anucha Apisarnthanarak⁸

Affiliations

¹ Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand.
² Department of Pharmaceutical care, Faculty of Pharmacy, Thammasat University, Prathum Thani, Thailand; Research group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand; Center of Excellence in Applied Epidemiology, Thammasat University, Prathum Thani, Thailand.
³ Division of Infectious Diseases, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
⁴ Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
⁵ Research group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand; Center of Excellence in Applied Epidemiology, Thammasat University, Prathum Thani, Thailand; Department of Pediatrics, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand.
⁶ Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand; Research group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand; Center of Excellence in Applied Epidemiology, Thammasat University, Prathum Thani, Thailand.
⁷ Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
⁸ Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand; Research group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Prathum Thani, Thailand; Center of Excellence in Applied Epidemiology, Thammasat University, Prathum Thani, Thailand. Electronic address: anapisarn@yahoo.com.

Abstract

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).

Keywords: Antibiotic stewardship; COVID-19; Inappropriate antibiotic use; Intensive care; Strategy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / therapeutic use
Biomarkers
COVID-19 Drug Treatment*
Communicable Diseases* / drug therapy
Critical Illness
Feasibility Studies
Humans
Pilot Projects
Pneumonia* / drug therapy
Procalcitonin

Substances

Anti-Bacterial Agents
Biomarkers
Procalcitonin