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Utility and safety of procalcitonin in an antimicrobial stewardship program (ASP) in patients with malignancies

  • Y. X. Liew
  • W. Lee
  • Y. Y. Cai
  • J. Teo
  • S. S.-L. Tang
  • R. W.-Q. Ong
  • C. L.-L. Lim
  • P. B. Lingegowda
  • A. L.-H. KwaEmail author
  • M. P. Chlebicki
Article

Abstract

As data on procalcitonin utility in antibiotics discontinuation [under an antimicrobial stewardship program (ASP)] in patients with malignancies are lacking, we aimed to evaluate the utility of procalcitonin in an ASP in patients with malignancies. We conducted a retrospective review of the ASP database of all patients with malignancies in whom at least one procalcitonin level was taken and our ASP had recommended changes in carbapenem regimen, from January to December 2011. We compared clinical outcomes between two groups of patients: patients whose physicians accepted and those whose physicians rejected ASP interventions. There were 749 carbapenem cases reviewed. Ninety-nine were suggested to either de-escalate, discontinue antibiotics, or narrow the spectrum of empiric treatment, based on procalcitonin trends. While there was no statistical difference in the mortality within 30 days post-ASP intervention (accepted: 8/65 patients vs. rejected: 9/34 patients; p = 0.076), the median duration of carbapenem therapy was significantly shorter (5 vs. 7 days; p = 0.002). Procalcitonin use safely facilitates decisions on antibiotics discontinuation and de-escalation in patients with malignancies in the ASP.

Keywords

Febrile Neutropenia Procalcitonin Carbapenem Antimicrobial Stewardship Program Procalcitonin Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Financial support

This study received no financial support of any type.

Conflict of interest

Kwa AL-H has received fundings for research from Janssen-Cilag, Pfizer, and Merck Sharp & Dohme (I.A.) Corp. The rest of the authors do not have any potential conflict of interest to declare.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Y. X. Liew
    • 1
  • W. Lee
    • 1
  • Y. Y. Cai
    • 1
  • J. Teo
    • 1
  • S. S.-L. Tang
    • 1
  • R. W.-Q. Ong
    • 1
  • C. L.-L. Lim
    • 1
  • P. B. Lingegowda
    • 2
  • A. L.-H. Kwa
    • 1
    Email author
  • M. P. Chlebicki
    • 2
  1. 1.Department of PharmacySingapore General HospitalSingaporeSingapore
  2. 2.Department of Infectious DiseasesSingapore General HospitalSingaporeSingapore

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