Abstract
Background: This is the first study that incorporated pharmacy into procalcitonin (PCT) level monitoring. Objective: The primary objective was to explore if implementing a pharmacist coordinated PCT level monitoring protocol can assist in safely reducing antibiotic use duration. The secondary objective was to investigate the accuracy and acceptance rate of implementing a pharmacist coordinated PCT protocol at the studied hospital. Methods: This was a case-control study at a single facility. Patient cases were selected based on the inclusion and exclusion criteria. The analysis compared the first 50 pneumonia and/or sepsis cases from the previous year without PCT guidance (control) to the cases with the PCT protocol (case). The primary outcome was duration of antibiotic therapy. Secondary outcomes evaluated length of hospital stay, rates of rehospitalization due to same diagnosis within one month, accuracy of successful PCT protocol implementation, and rate of acceptance of pharmacist’s recommendations by hospitalists. Analysis comparing pharmacy coordinated PCT protocol to past data with no PCT protocol guidance was conducted. Results: There were 50 patients in the control group and 38 patients in the case group. The duration of antibiotic therapy was shorter for the PCT-guided group (4.45 vs 5.62 days, p=0.052). The findings for secondary results favored implementing pharmacy coordinated PCT monitoring protocol. Conclusions: Our study suggests that the pharmacy coordinated PCT monitoring protocol can be safely implemented to guide antibiotic therapy for sepsis and pneumonia patients.
Keywords antibiotics, bacterial infections, clinical pharmacy, pneumonia, procalcitonin, sepsis.