Does Procalcitonin Testing in COPD Impact Antibiotic Rx?
Researchers found a weak negative association between PCT testing rate and risk-adjusted antibiotic initiation rate.
HealthDay News — Hospital adoption of procalcitonin (PCT) testing has had little impact on antibiotic prescribing for chronic obstructive pulmonary disease (COPD) exacerbations, according to a study published online in the Annals of the American Thoracic Society.
Peter K. Lindenauer, MD, from Baystate Medical Center in Springfield, MA, determined the impact of PCT testing on antibiotic treatment of patients hospitalized for exacerbations of COPD in routine practice. The authors evaluated data from 505 hospitals (2009 to 2011 and 2013 to 2014).
The researchers found that of 203,177 patients hospitalized for COPD exacerbation in 2013 to 2014, nearly 9 out of 10 were treated with antibiotics, while hospital PCT testing rates ranged from 0% to 83%. There was a weak negative association between the rate of PCT testing and risk-adjusted rates of antibiotic initiation (P =.005), with each 10 point increase in the percentage of patients undergoing PCT testing associated with a 0.7% decline in risk-adjusted antibiotic use (P =.001). There was not a significant change in antibiotic treatment rates or duration of therapy between hospitals that had adopted PCT testing compared to those that had not, when comparing treatment patterns between 2009 to 2011 and 2013 to 2014.
"As currently implemented, PCT testing appears to have had little impact on decisions to initiate antibiotic therapy or on duration of treatment for COPD exacerbations," the authors write.
Lindenauer PK, Shieh M-S, Stefan MS, et al. Hospital procalcitonin testing and antibiotic treatment of patients admitted for COPD exacerbation [published online August 10, 2017]. Ann Am Thorac Soc. doi:10.1513/AnnalsATS.201702-133OC