☆ 4.6 Review

Procalcitonin as a Tool to Antimicrobial Stewardship in COVID-19 Patients with Superimposed Bacterial Infections: A Systematic Review

JOURNAL OF INFLAMMATION RESEARCH (2022)

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Article Pharmacology & Pharmacy

Antibiotic stewardship: Early discontinuation of antibiotics based on procalcitonin level in COVID-19 pneumonia

Archana Roy et al.

Summary: Procalcitonin levels rise in systemic inflammation, especially if bacterial in origin. Elevated procalcitonin in COVID-19 is considered as a marker for disease severity, but its association with superimposed bacterial infection remains unclear. This study evaluated the association between PCT levels and bacterial infection in COVID-19 pneumonia, finding that most patients have low PCT levels, supporting existing literature on viral pneumonia. Early discontinuation of antibiotics in low PCT patients did not result in adverse outcomes and was linked to shorter hospital stays.

JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS (2022)

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Article Multidisciplinary Sciences

Baseline procalcitonin as a predictor of bacterial infection and clinical outcomes in COVID-19: A case-control study

Natalie J. Atallah et al.

Summary: This study evaluates whether procalcitonin (PCT) can predict clinical outcome and bacterial superinfection in patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The results suggest that baseline PCT levels are associated with outcome and bacterial superinfection in patients hospitalized with SARS-CoV-2.

PLOS ONE (2022)

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Article Infectious Diseases

Bacterial co-infection at hospital admission in patients with COVID-19

Estela Moreno-Garcia et al.

Summary: This study describes the incidence and risk factors of bacterial co-infection in hospitalized patients with COVID-19. The findings indicate that bacterial co-infections are relatively common, and PCT values and other indicators can be used as references for diagnosis and treatment.

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES (2022)

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Article Public, Environmental & Occupational Health

Co-infection of Uropathogenic Escherichia coil among COVID-19 Patients Admitted to a Tertiary Care Centre: A Descriptive Cross-sectional Study

Ajaya Basnet et al.

Summary: This study investigated the co-infection rate of uropathogenic Escherichia coli in hospitalized COVID-19 patients and found a low prevalence of co-infection. The serum procalcitonin value in co-infected patients was significantly higher than in non-co-infected patients.

JOURNAL OF NEPAL MEDICAL ASSOCIATION (2022)

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Article Medicine, General & Internal

Use of procalcitonin for antibiotic stewardship in patients with COVID-19: A quality improvement project in a district general hospital

Christina Peters et al.

Summary: The use of procalcitonin (PCT) testing in combination with thorough clinical assessment plays an important role in antibiotic stewardship during the COVID-19 pandemic, reducing antibiotic use and improving patient outcomes.

CLINICAL MEDICINE (2021)

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Letter Medicine, General & Internal

Procalcitonin accurately predicts mortality but not bacterial infection in COVID-19 patients admitted to intensive care unit

Charlotte Vanhomwegen et al.

IRISH JOURNAL OF MEDICAL SCIENCE (2021)

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Article Microbiology

Limited Utility of Procalcitonin in Identifying Community-Associated Bacterial Infections in Patients Presenting with Coronavirus Disease 2019

Michael May et al.

Summary: The role of procalcitonin in identifying community-associated bacterial infections among patients with coronavirus disease 2019 is not yet established. Procalcitonin did not reliably identify bacterial coinfections, but may be useful in excluding bacterial infection.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

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Article Infectious Diseases

Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS

Owen Richards et al.

Summary: The study revealed a significant association between an increase in PCT levels and the occurrence of secondary bacterial infection in critically ill COVID-19 patients, suggesting the potential usefulness of PCT measurement in predicting such infections.

ANTIBIOTICS-BASEL (2021)

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Article Emergency Medicine

Clinical value of procalcitonin in critically ill patients infected by SARS-CoV-2

Pedro Garrido et al.

Summary: In this single-center retrospective cohort study of COVID-19 patients admitted between March and May 2020, non-survivors in the ICU had significantly higher initial blood PCT levels compared to survivors.

AMERICAN JOURNAL OF EMERGENCY MEDICINE (2021)

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Article Infectious Diseases

Informing antimicrobial management in the context of COVID-19: understanding the longitudinal dynamics of C-reactive protein and procalcitonin

Damien K. Ming et al.

Summary: The study showed that CRP concentrations in COVID-19 patients increased over time in hospital, especially in those with positive microbiology or those who died. PCT concentrations were higher in patients with positive microbiology or in those who died, although not statistically significant. The first week CRP concentration and trajectory are important for predicting microbiology culture positivity and outcomes in COVID-19 patients.

BMC INFECTIOUS DISEASES (2021)

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Article Infectious Diseases

C-reactive protein and procalcitonin for antimicrobial stewardship in COVID-19

Isabell Pink et al.

Summary: The study retrospectively analyzed patients admitted with COVID-19 between March 6th and October 30th, 2020. It found that PCT and CRP levels may be helpful in differentiating secondary bacterial infections in patients with COVID-19.ROC analysis showed that PCT and CRP had high efficacy in identifying secondary bacterial infections, with specific cut-off values for optimal sensitivity and specificity.

INFECTION (2021)

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Article Medical Laboratory Technology

Elevated procalcitonin concentrations in severe Covid-19 may not reflect bacterial co-infection

Randeep S. Heer et al.

Summary: Elevated procalcitonin concentrations in COVID-19 patients are associated with respiratory failure, prolonged invasive mechanical ventilation, and inpatient mortality, which may be independent of bacterial co-infection.

ANNALS OF CLINICAL BIOCHEMISTRY (2021)

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Article Infectious Diseases

Procalcitonin to Guide Antibacterial Prescribing in Patients Hospitalised with COVID-19

Stephen Hughes et al.

Summary: This study explores the potential role of PCT in excluding bacterial co-infection in COVID-19 patients. A negative PCT result is associated with shorter antimicrobial courses, early cessation of therapy, and a lower frequency of ICU admission.

ANTIBIOTICS-BASEL (2021)

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Article Infectious Diseases

Evaluation of serum procalcitonin level as a biomarker for disease severity in COVID-19 patients

A. Waris et al.

Summary: The study aimed to evaluate serum PCT level as a biomarker for bacterial co-infection and disease severity in COVID-19 patients. The total serum level of PCT increased with disease severity. Gender was not associated with PCT value, but age and PCT value in COVID-19 patients showed significant correlation.

NEW MICROBES AND NEW INFECTIONS (2021)

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Article Medicine, Research & Experimental

Co-Infection with Common Respiratory Pathogens and SARS-CoV-2 in Patients with COVID-19 Pneumonia and Laboratory Biochemistry Findings: A Retrospective Cross-Sectional Study of 78 Patients from a Single Center in China

Man-Ling Tang et al.

Summary: This retrospective study in the Zhuzhou area of China found that Mycoplasma pneumoniae and respiratory syncytial virus were the most common co-infections in patients with COVID-19 pneumonia. Patients with co-infections showed significantly higher levels of procalcitonin.

MEDICAL SCIENCE MONITOR (2021)

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Review Immunology

Procalcitonin to Distinguish Viral From Bacterial Pneumonia: A Systematic Review and Meta-analysis

Ishan S. Kamat et al.

CLINICAL INFECTIOUS DISEASES (2020)

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Letter Medical Laboratory Technology

Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis

Giuseppe Lippi et al.

CLINICA CHIMICA ACTA (2020)

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Editorial Material Infectious Diseases

Procalcitonin as an antibiotic stewardship tool in COVID-19 patients in the intensive care unit

Lesley Heesom et al.

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE (2020)

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Article Health Care Sciences & Services

Analysis of the Risk Factors for Nosocomial Bacterial Infection in Patients with COVID-19 in a Tertiary Hospital

Keping Cheng et al.

RISK MANAGEMENT AND HEALTHCARE POLICY (2020)

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Article Critical Care Medicine

Procalcitonin Algorithm in Critically Ill Adults with Undifferentiated Infection or Suspected Sepsis A Randomized Controlled Trial

Yahya Shehabi et al.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)

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Article Medicine, General & Internal

Procalcitonin levels to guide antibiotic therapy in adults with non-microbiologically proven apparent severe sepsis: a randomised controlled trial

Djillali Annane et al.

BMJ OPEN (2013)

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Article Critical Care Medicine

Use of procalcitonin to shorten antibiotic treatment duration in septic patients - A randomized trial

Vandack Nobre et al.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2008)

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Article Pediatrics

Cytokine profiles in the respiratory tract during primary infection with human metapneumovirus, respiratory syncytial virus, or influenza virus in infants

Guillermina A. Melendi et al.

PEDIATRICS (2007)

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Review Immunology

Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: A systematic review and meta-analysis

L Simon et al.

CLINICAL INFECTIOUS DISEASES (2004)

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