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Antibiotic Usage After Procalcitonin-Guided Therapy Algorithm Implementation In A Burn Intensive Care Unit.

V Zbyrak1, S L Reverón1, S Smoke1

  • 1Saint Barnabas Medical Center, Livingston, NJ, USA.

Annals of Burns and Fire Disasters
|March 12, 2021
PubMed
Summary
This summary is machine-generated.

This study evaluated a procalcitonin (PCT)-guided antibiotic algorithm in a burn intensive care unit (BICU). While showing promise in reducing antibiotic days, small sample size limits definitive conclusions on its effectiveness for antibiotic stewardship.

Keywords:
DOORRADARalgorithmantibioticsprocalcitoninsepsis

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Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Antibiotic resistance necessitates strategies to minimize antimicrobial exposure.
  • Burn intensive care units (BICUs) are high-risk environments for infections requiring judicious antibiotic use.

Purpose of the Study:

  • To assess the impact of a procalcitonin (PCT)-guided antibiotic algorithm on antibiotic utilization in a BICU.
  • To evaluate secondary outcomes including reinitiation of antibiotics, length of stay, and mortality.

Main Methods:

  • A retrospective and prospective study design was employed.
  • Implementation of a PCT-guided algorithm for antibiotic ordering and monitoring.
  • Utilized Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR) for evaluation.

Main Results:

  • Median antibiotic days in BICU decreased from 33.3% to 14.3% (p=0.222) post-algorithm implementation.
  • Significant reductions observed in patients reinitiated on antibiotics (80.0% vs 28.6%, p=0.242).
  • Probability of better DOOR was 95.7% favoring the PCT-guided algorithm.

Conclusions:

  • The PCT-guided algorithm demonstrated a trend towards reduced antibiotic exposure and reinitiation in burn patients.
  • Small sample size limited statistical power and internal validity, precluding definitive conclusions.
  • Further research with larger cohorts is warranted to confirm the benefits of PCT-guided stewardship in burn populations.