Photo Credit: Pornpak Khunatorn
The following is a summary of “Evaluation of pharmacist guided intervention using procalcitonin and respiratory virus testing,” published in the April 2023 issue of Emergency Medicine by Andrade, et al.
Acute respiratory infections are common causes of Emergency Department (ED) visits, and many of these visits result in the prescription of antibiotics. However, it remains underused in the ED despite the proven effectiveness of procalcitonin (PCT) in reducing antibiotic use in outpatient and critical care settings. For a study, researchers sought to evaluate whether the combination of point-of-care molecular influenza and respiratory syncytial virus (RSV) testing, PCT, and a pharmacist-led educational intervention could optimize antibiotic and antiviral prescribing in the ED setting.
A randomized trial involved patients aged 0-50 years who presented to the ED with Influenza-like Illness (ILI) or acute respiratory illness. The study enrolled 200 ED patients between March 2018 and April 2022. Participants were randomly assigned to either the intervention or control group. The intervention group received point-of-care molecular influenza and RSV testing, PCT, and a pharmacist-led educational intervention, while the control group received usual care.
The study found little difference in antibiotic or antiviral prescribing between the intervention and control groups (39%–32% = 7.0%, 95% CI: −6.2, 20.2, P = 0.30). However, a post-hoc analysis of the use of PCT showed that results were used as indicated in the ED (P = 0.001).
The study results suggested that PCT can be used effectively in both adult and pediatric populations to guide the decision of whether to treat with antibiotics in the ED setting. However, the pharmacist-led educational intervention did not significantly impact antibiotic or antiviral prescribing.
Source: sciencedirect.com/science/article/abs/pii/S0735675723000451
