ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Use of Procalcitonin and a Respiratory Polymerase Chain Reaction Panel to Reduce Antibiotic Use via an Electronic Medical Record Alert.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Procalcitonin-guided antibiotic prescription in patients with respiratory syncytial virus and influenza virus.BMJ open respiratory research · 2025Article
- Impact of Real-Time Multiplex PCR Testing for Respiratory Viruses on Antibiotic Use.Infectious diseases & clinical microbiology · 2025Article
- Rapid Molecular Diagnostics of Pneumonia Caused by Gram-Negative Bacteria: A Clinician's Review.Antibiotics (Basel, Switzerland) · 2024Review
- Breaking Boundaries in Pneumonia Diagnostics: Transitioning from Tradition to Molecular Frontiers with Multiplex PCR.Diagnostics (Basel, Switzerland) · 2024Review
- The importance of pharmacist engagement in diagnostic stewardship.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Effect of Best Practice Alert (BPA) on Post-Discharge Opioid Prescribing After Minimally Invasive Hysterectomy: A Quality Improvement Study.Journal of pain research · 2024Article
- Crossroads of Antimicrobial and Diagnostic Stewardship: Assessing Risks to Develop Clinical Decision Support to Combat Multidrug-ResistantOpen forum infectious diseases · 2023Article
- A multimodal antimicrobial stewardship intervention to improve antibiotic prescribing in patients with COVID-19.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Measuring clinical outcomes of highly multiplex molecular diagnostics for respiratory infections: A systematic review and conceptual framework.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Leveraging diagnostic stewardship within antimicrobial stewardship programmes.Drugs in context · 2023Review
- Core Elements for Implementing Antimicrobial Stewardship Programs in Korean General Hospitals.Infection & chemotherapy · 2022Review
- Utility and Applicability of Rapid Diagnostic Testing in Antimicrobial Stewardship in the Asia-Pacific Region: A Delphi Consensus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Molecular diagnostics in severe pneumonia: a new dawn or false promise?Intensive care medicine · 2022Article
- Value of syndromic panels in the management of severe community-acquired pneumonia.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Review
- Diagnostic Stewardship as a Team Sport: Interdisciplinary Perspectives on Improved Implementation of Interventions and Effect Measurement.Antibiotics (Basel, Switzerland) · 2022Review
- Guidelines on Implementing Antimicrobial Stewardship Programs in Korea.Infection & chemotherapy · 2021Review
- Update on Coagulase-Negative Staphylococci-What the Clinician Should Know.Microorganisms · 2021Review
- Impact of BioFire FilmArray respiratory panel results on antibiotic days of therapy in different clinical settings.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2021Article
- A three-marker protein biosignature distinguishes tuberculosis from other respiratory diseases in Gambian children.EBioMedicine · 2020Article
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRespiratory tract infections are often viral and but are frequently treated with antibiotics, providing a significant opportunity for antibiotic de-escalation in patients. We sought to determine whether an automated electronic medical record best practice alert (BPA) based on procalcitonin and respiratory polymerase chain reaction (PCR) results could help reduce inappropriate antibiotic use in patients with likely viral respiratory illness.
methodsThis multisite, pre-post, quasi-experimental study included patients 18 years and older with a procalcitonin level <0.25 ng/mL and a virus identified on respiratory PCR within 48 hours of each other, and 1 or more systemic antibiotics ordered. In the study group, a BPA alerted providers of the diagnostic results suggesting viral infection and prompted them to reassess the need for antibiotics. The primary outcome measured was total antibiotic-days of therapy.
resultsThe BPA reduced inpatient antibiotic-days of therapy by a mean of 2.2 days compared with patients who met criteria but did not have the alert fire (8.0 vs 5.8 days, respectively, P < .001). The BPA also reduced the percentage of patients prescribed antibiotics on discharge (20% vs 47.8%, P < .001), whereas there was no difference in need for antibiotic escalation after initial discontinuation (7.6% vs 4.3%, P = .198).
conclusionsThe automated antimicrobial stewardship BPA effectively reduced antibiotic use and discharge prescribing rates when diagnostics suggested viral respiratory tract infection, without a higher rate for reinitiation of antibiotics after discontinuation.
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