ArticleBMJ open2025
Procalcitonin to guide antibiotic use during the first wave of COVID-19 in English and Welsh hospitals: integration and triangulation of findings from quantitative and qualitative sources.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo integrate the quantitative and qualitative data collected as part of the PEACH (Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients) study, which evaluated whether procalcitonin (PCT) testing should be used to guide antibiotic prescribing and safely reduce antibiotic use among patients admitted to acute UK National Health Service (NHS) hospitals.
designTriangulation to integrate quantitative and qualitative data. SETTING AND
participantsFour data sources in 148 NHS hospitals in England and Wales including data from 6089 patients.
methodA triangulation protocol was used to integrate three quantitative data sources (survey, organisation-level data and patient-level data: data sources 1, 2 and 3) and one qualitative data source (clinician interviews: data source 4) collected as part of the PEACH study. Analysis of data sources initially took place independently, and then, key findings for each data source were added to a matrix. A series of interactive discussion meetings took place with quantitative, qualitative and clinical researchers, together with patient and public involvement (PPI) representatives, to group the key findings and produce seven statements relating to the study objectives. Each statement and the key findings related to that statement were considered alongside an assessment of whether there was agreement, partial agreement, dissonance or silence across all four data sources (convergence coding). The matrix was then interpreted to produce a narrative for each statement.
objectiveTo explore whether PCT testing safely reduced antibiotic use during the first wave of the COVID-19 pandemic.
resultsSeven statements were produced relating to the PEACH study objective. There was agreement across all four data sources for our first key statement, 'During the first wave of the pandemic (01/02/2020-30/06/2020), PCT testing reduced antibiotic prescribing'. The second statement was related to this key statement, 'During the first wave of the pandemic (01/02/2020-30/06/2020), PCT testing
conclusionThere was agreement between all four data sources on our key finding 'during the first wave of the pandemic (01/02/2020-30/06/2020), PCT testing reduced antibiotic prescribing'. Data, methodological and investigator triangulation, and a transparent triangulation protocol give validity to this finding. TRIAL REGISTRATION NUMBER: ISRCTN66682918.
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