Procalcitonin-guided antibiotic prescription in patients with respiratory syncytial virus (RSV) and influenza virus

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Background: Bacterial co-infections may occur in patients with influenza and RSV, often leading to high unnecessary antibiotic exposure. Procalcitonin (PCT) may help reduce inappropriate antibiotic prescriptions in viral infections. Methods: In this retrospective study data analysed from 558 influenza and 175 RSV patients (2017-2024). Patients were divided into PCT (antibiotic prescription guided by PCT levels) and control groups (antibiotic prescription based on clinical judgment). Outcomes included antibiotic use, Defined Daily Dose (DDD), duration of antibiotic treatment (DOT), and secondary outcomes (readmissions, ICU admissions, mortality, mechanical ventilation). Results: At admission, 273 Influenza control patients (49.6%) and 271 PCT patients (53.2%) received antibiotics (adjusted OR 1.24, 95% CI 0.81–1.91, p = 0.325), indicating no significant difference. For RSV patients, 73 control patients (41.7%) and 86 PCT patients (49.3%) received antibiotics (adjusted OR 1.32, 95% CI 0.60–2.91, p = 0.490), also showing no significant difference. No significant differences in DOT or DDD were observed for either group. PCT testing showed no significant impact on secondary outcomes. Conclusion: PCT testing did not significantly reduce antibiotic use or dosage, suggesting limited utility for optimizing antibiotic use in influenza and RSV infections.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.