Use of procalcitonin during the first wave of COVID-19 in the acute NHS hospitals: a retrospective observational study

Powell, Neil, Howard, Philip, Llewelyn, Martin J., Szakmany, Tamas ORCID: https://orcid.org/0000-0003-3632-8844, Albur, Mahableshwar, Bond, Stuart E., Euden, Joanne ORCID: https://orcid.org/0000-0002-2844-6878, Brookes-Howell, Lucy ORCID: https://orcid.org/0000-0002-8263-7130, Dark, Paul, Hellyer, Thomas P., Hopkins, Susan, McCullagh, Iain J., Ogden, Margaret, Pallmann, Philip ORCID: https://orcid.org/0000-0001-8274-9696, Parsons, Helena, Partridge, David G., Shaw, Dominick E., Shinkins, Bethany, Todd, Stacy, Thomas-Jones, Emma ORCID: https://orcid.org/0000-0001-7716-2786, West, Robert, Carrol, Enitan D. and Sandoe, Jonathan A. T. 2021. Use of procalcitonin during the first wave of COVID-19 in the acute NHS hospitals: a retrospective observational study. Antibiotics 10 (5) , 516. 10.3390/antibiotics10050516

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Abstract

A minority of patients presenting to hospital with COVID-19 have bacterial co-infection. Procalcitonin testing may help identify patients for whom antibiotics should be prescribed or withheld. This study describes the use of procalcitonin in English and Welsh hospitals during the first wave of the COVID-19 pandemic. A web-based survey of antimicrobial leads gathered data about the use of procalcitonin testing. Responses were received from 148/151 (98%) eligible hospitals. During the first wave of the COVID-19 pandemic, there was widespread introduction and expansion of PCT use in NHS hospitals. The number of hospitals using PCT in emergency/acute admissions rose from 17 (11%) to 74/146 (50.7%) and use in Intensive Care Units (ICU) increased from 70 (47.6%) to 124/147 (84.4%). This increase happened predominantly in March and April 2020, preceding NICE guidance. Approximately half of hospitals used PCT as a single test to guide decisions to discontinue antibiotics and half used repeated measurements. There was marked variation in the thresholds used for empiric antibiotic cessation and guidance about interpretation of values. Procalcitonin testing has been widely adopted in the NHS during the COVID-19 pandemic in an unevidenced, heterogeneous way and in conflict with relevant NICE guidance. Further research is needed urgently that assesses the impact of this change on antibiotic prescribing and patient safety

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Publisher:	MDPI
ISSN:	2079-6382
Date of First Compliant Deposit:	4 May 2021
Date of Acceptance:	29 April 2021
Last Modified:	05 May 2023 01:30
URI:	https://orca.cardiff.ac.uk/id/eprint/140905

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