Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia

Thomas L. Walsh, Briana E. DiSilvio, Crystal Hammer, Moeezullah Beg, Swati Vishwanathan, Daniel Speredelozzi, Matthew A. Moffa, Kurt Hu, Rasha Abdulmassih, Jina Makadia, Rikinder Sandhu, Mouhib Naddour, Noreen H. Chan-Tompkins, Tamara L. Trienski, Courtney Watson, Terrence J. Obringer, Jim Kuzyck, Derek N. Bremmer

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Community-acquired pneumonia and healthcare-associated pneumonia are often treated with prolonged antibiotic therapy. Procalcitonin (PCT) has effectively and safely reduced antibiotic use for pneumonia in controlled studies. However, limited data exist regarding PCT guidance in real-world settings for management of pneumonia. Methods: A retrospective, preintervention/postintervention study was conducted to compare management for patients admitted with pneumonia before and after implementation of PCT guidance at 2 teaching hospitals in Pittsburgh, Pennsylvania. The preintervention period was March 1, 2014 through October 31, 2014, and the postintervention period was March, 1 2015 through October 31, 2015. Results: A total of 152 and 232 patients were included in the preintervention and postintervention cohorts, respectively. When compared with the preintervention group, mean duration of therapy decreased (9.9 vs 6.0 days; P <.001). More patients received an appropriate duration of 7 days or less (26.9% vs 66.4%; P <.001). Additionally, mean hospital length of stay decreased in the postintervention group (4.9 vs 3.5 days; P =.006). Pneumonia-related 30-day readmission rates (7.2% vs 4.3%; P =.26) were unaffected. In the postintervention group, patients with PCT levels <0.25 µg/L received shorter mean duration of therapy compared with patients with levels >0.25 µg/L (4.6 vs 8.0 days; P <.001), as well as reduced hospital length of stay (3.2 vs 3.9 days; P =.02). Conclusions: In this real-world study, PCT guidance led to shorter durations of total antibiotic therapy and abridged inpatient length of stay without affecting hospital readmissions.

Original languageEnglish (US)
Pages (from-to)201.e1-201.e8
JournalAmerican Journal of Medicine
Volume131
Issue number2
DOIs
StatePublished - Feb 1 2018
Externally publishedYes

Fingerprint

Calcitonin
Pneumonia
Length of Stay
Anti-Bacterial Agents
Patient Readmission
Teaching Hospitals
Inpatients
Therapeutics
Delivery of Health Care

Keywords

  • Community-acquired pneumonia
  • Healthcare-associated pneumonia
  • Procalcitonin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Walsh, T. L., DiSilvio, B. E., Hammer, C., Beg, M., Vishwanathan, S., Speredelozzi, D., ... Bremmer, D. N. (2018). Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia. American Journal of Medicine, 131(2), 201.e1-201.e8. https://doi.org/10.1016/j.amjmed.2017.08.039

Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia. / Walsh, Thomas L.; DiSilvio, Briana E.; Hammer, Crystal; Beg, Moeezullah; Vishwanathan, Swati; Speredelozzi, Daniel; Moffa, Matthew A.; Hu, Kurt; Abdulmassih, Rasha; Makadia, Jina; Sandhu, Rikinder; Naddour, Mouhib; Chan-Tompkins, Noreen H.; Trienski, Tamara L.; Watson, Courtney; Obringer, Terrence J.; Kuzyck, Jim; Bremmer, Derek N.

In: American Journal of Medicine, Vol. 131, No. 2, 01.02.2018, p. 201.e1-201.e8.

Research output: Contribution to journalArticle

Walsh, TL, DiSilvio, BE, Hammer, C, Beg, M, Vishwanathan, S, Speredelozzi, D, Moffa, MA, Hu, K, Abdulmassih, R, Makadia, J, Sandhu, R, Naddour, M, Chan-Tompkins, NH, Trienski, TL, Watson, C, Obringer, TJ, Kuzyck, J & Bremmer, DN 2018, 'Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia', American Journal of Medicine, vol. 131, no. 2, pp. 201.e1-201.e8. https://doi.org/10.1016/j.amjmed.2017.08.039
Walsh, Thomas L. ; DiSilvio, Briana E. ; Hammer, Crystal ; Beg, Moeezullah ; Vishwanathan, Swati ; Speredelozzi, Daniel ; Moffa, Matthew A. ; Hu, Kurt ; Abdulmassih, Rasha ; Makadia, Jina ; Sandhu, Rikinder ; Naddour, Mouhib ; Chan-Tompkins, Noreen H. ; Trienski, Tamara L. ; Watson, Courtney ; Obringer, Terrence J. ; Kuzyck, Jim ; Bremmer, Derek N. / Impact of Procalcitonin Guidance with an Educational Program on Management of Adults Hospitalized with Pneumonia. In: American Journal of Medicine. 2018 ; Vol. 131, No. 2. pp. 201.e1-201.e8.
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AU - Hammer, Crystal

AU - Beg, Moeezullah

AU - Vishwanathan, Swati

AU - Speredelozzi, Daniel

AU - Moffa, Matthew A.

AU - Hu, Kurt

AU - Abdulmassih, Rasha

AU - Makadia, Jina

AU - Sandhu, Rikinder

AU - Naddour, Mouhib

AU - Chan-Tompkins, Noreen H.

AU - Trienski, Tamara L.

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N2 - Background: Community-acquired pneumonia and healthcare-associated pneumonia are often treated with prolonged antibiotic therapy. Procalcitonin (PCT) has effectively and safely reduced antibiotic use for pneumonia in controlled studies. However, limited data exist regarding PCT guidance in real-world settings for management of pneumonia. Methods: A retrospective, preintervention/postintervention study was conducted to compare management for patients admitted with pneumonia before and after implementation of PCT guidance at 2 teaching hospitals in Pittsburgh, Pennsylvania. The preintervention period was March 1, 2014 through October 31, 2014, and the postintervention period was March, 1 2015 through October 31, 2015. Results: A total of 152 and 232 patients were included in the preintervention and postintervention cohorts, respectively. When compared with the preintervention group, mean duration of therapy decreased (9.9 vs 6.0 days; P <.001). More patients received an appropriate duration of 7 days or less (26.9% vs 66.4%; P <.001). Additionally, mean hospital length of stay decreased in the postintervention group (4.9 vs 3.5 days; P =.006). Pneumonia-related 30-day readmission rates (7.2% vs 4.3%; P =.26) were unaffected. In the postintervention group, patients with PCT levels <0.25 µg/L received shorter mean duration of therapy compared with patients with levels >0.25 µg/L (4.6 vs 8.0 days; P <.001), as well as reduced hospital length of stay (3.2 vs 3.9 days; P =.02). Conclusions: In this real-world study, PCT guidance led to shorter durations of total antibiotic therapy and abridged inpatient length of stay without affecting hospital readmissions.

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