Can Procalcitonin Facilitate Antimicrobial Stewardship in Patients with COVID-19?

Serum procalcitonin below 0.5 ng/mL helped rule out bacterial infections — but elevated levels, common in patients with severe COVID-19, were not useful.

Although procalcitonin (PCT) testing has been promoted for discriminating bacterial from viral causes of infection, thereby averting unnecessary antibiotic use, the 2019 ATS/IDSA guidelines on management of community acquired pneumonia recommend against use of PCT to guide antibiotic prescribing in such patients (NEJM JW Infect Dis Dec 2019 and Am J Respir Crit Care Med 2019; 200:e45). Nevertheless, the COVID-19 pandemic has heightened the relevance of this clinical dilemma.

Investigators conducted a retrospective cohort study of 2443 patients who underwent PCT measurements within 72 hours of presenting with COVID-19 at two hospital emergency departments in New York City. Concurrent bacterial infections were categorized into bacteremia, pneu…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases