{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:51Z","timestamp":1787755131334,"version":"build-2784847793"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"Supplement_4","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Procalcitonin (PCT) levels may play a role in decreasing the duration of antimicrobial therapy in institutions that have long durations of therapy for management of community-acquired pneumonia. We assessed the impact of the combination of pharmacist stewardship interventions assisted by a clinical decision support (CDS) tool and PCT assessment on the antimicrobial days of therapy (DOT) prescribed for respiratory tract infections (RTIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a quasi-experimental study in which patients in the preintervention group were admitted between April and June 2021 and patients in the intervention group were admitted between April and June 2022. In the intervention phase, a CDS tool was utilized to alert clinical pharmacists when patients met specific criteria. This alert was programmed to activate for individual patients when a reported PCT level was less than 0.25 ng\/mL and the patient was on antimicrobials prescribed for an RTI as indicated by providers in the electronic health record. Stewardship interventions were made by pharmacists via prospective audit and feedback. The primary endpoint was inpatient antimicrobial DOT for RTIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 90 patients in the preintervention group and 104 patients in the intervention group. Although baseline characteristics were not well matched between the groups, favoring the preintervention group, the median DOT was lower in the intervention group, at 3 days (interquartile range [IQR], 2-4 days), compared to 4 days (IQR, 2.8-5 days) in the preintervention group (P = 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The results of our study demonstrate the utility of pharmacist interventions coupled with CDS and PCT in reducing antimicrobial DOT prescribed for RTIs. Antimicrobial stewardship programs may benefit from implementing a PCT bundle.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae072","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T15:13:42Z","timestamp":1710515622000},"page":"S137-S143","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the utility of procalcitonin and a clinical decision support tool to determine duration of antimicrobial therapy for respiratory tract infections"],"prefix":"10.1093","volume":"81","author":[{"given":"Rustin","family":"Pevehouse","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Houston Methodist Sugar Land Hospital , Sugar Land, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punit J","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Houston Methodist Sugar Land Hospital , Sugar Land, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitha","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Houston Methodist Sugar Land Hospital , Sugar Land, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Oolut","sequence":"additional","affiliation":[{"name":"Houston Methodist Sugar Land Hospital , Sugar Land, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneesh","family":"Nair","sequence":"additional","affiliation":[{"name":"Houston Methodist Sugar Land Hospital , Sugar Land, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raziuddin","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Houston Methodist Sugar Land Hospital , Sugar Land, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"issue":"10","key":"2024081914141034000_CIT0001","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1093\/cid\/cir063","article-title":"Strategies for reduction in duration of antibiotic use in hospitalized patients","volume":"52","author":"Hayashi","year":"2011","journal-title":"Clin Infect Dis"},{"issue":"8","key":"2024081914141034000_CIT0002","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1093\/jac\/dkac162","article-title":"Why we prescribe antibiotics for too long in the hospital setting: a systematic scoping review","volume":"77","author":"Janssen","year":"2022","journal-title":"J Antimicrob Chemother"},{"issue":"4","key":"2024081914141034000_CIT0003","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1086\/526535","article-title":"The Maxwell Finland Lecture: For the duration\u2014rational antibiotic administration in an era of antimicrobial resistance and Clostridium difficile","volume":"46","author":"Rice","year":"2008","journal-title":"Clin Infect Dis"},{"issue":"suppl 2","key":"2024081914141034000_CIT0004","first-page":"ii33","article-title":"Diagnostic and prognostic biomarkers of sepsis in critical care","volume":"66","author":"Kibe","year":"2011","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"2024081914141034000_CIT0005","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1183\/09031936.00166106","article-title":"Biomarkers in respiratory tract infections: diagnostic guides to antibiotic prescription, prognostic markers and mediators","volume":"30","author":"Christ-Crain","year":"2007","journal-title":"Eur Respir J"},{"issue":"5","key":"2024081914141034000_CIT0006","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1515\/cclm-2022-1072","article-title":"How to best use procalcitonin to diagnose infections and manage antibiotic treatment","volume":"61","author":"Schuetz","year":"2022","journal-title":"Clin Chem Lab Med"},{"issue":"2","key":"2024081914141034000_CIT0007","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/cid\/cix317","article-title":"Procalcitonin as a marker of etiology in adults hospitalized with community-acquired pneumonia","volume":"65","author":"Self","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"4","key":"2024081914141034000_CIT0008","doi-asserted-by":"crossref","first-page":"e02167","DOI":"10.1128\/AAC.02167-20","article-title":"Limited utility of procalcitonin in identifying community-associated bacterial infections in patients presenting with coronavirus disease 2019","volume":"65","author":"May","year":"2021","journal-title":"Antimicrob Agents Chemother"},{"issue":"7","key":"2024081914141034000_CIT0009","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"11","key":"2024081914141034000_CIT0010","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1136\/thoraxjnl-2020-214896","article-title":"Severe respiratory viral infection induces procalcitonin in the absence of bacterial pneumonia","volume":"75","author":"Gautam","year":"2020","journal-title":"Thorax"},{"issue":"143","key":"2024081914141034000_CIT0011","doi-asserted-by":"crossref","first-page":"160073","DOI":"10.1183\/16000617.0073-2016","article-title":"Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis","volume":"26","author":"Mathioudakis","year":"2017","journal-title":"Eur Respir Rev"},{"issue":"3","key":"2024081914141034000_CIT0012","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3390\/pharmacy9030136","article-title":"Use of a novel clinical decision support tool for pharmacist-led antimicrobial stewardship in patients with normal procalcitonin","volume":"9","author":"Watkins","year":"2021","journal-title":"Pharmacy"},{"issue":"10","key":"2024081914141034000_CIT0013","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1001\/jama.2009.1297","article-title":"ProHOSP Study Group. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial","volume":"302","author":"Schuetz","year":"2009","journal-title":"JAMA"},{"issue":"12","key":"2024081914141034000_CIT0014","doi-asserted-by":"crossref","first-page":"ofy327","DOI":"10.1093\/ofid\/ofy327","article-title":"Procalcitonin-guided antibiotic therapy reduces antibiotic use for lower respiratory tract infections in a United States medical center: results of a clinical trial","volume":"5","author":"Townsend","year":"2018","journal-title":"Open Forum Infect Dis"},{"issue":"5","key":"2024081914141034000_CIT0015","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1177\/0018578720931450","article-title":"Evaluation of a pharmacist-driven procalcitonin protocol for lower respiratory tract infections using a clinical decision support system","volume":"56","author":"Teehan","year":"2021","journal-title":"Hosp Pharm"},{"issue":"1","key":"2024081914141034000_CIT0016","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S1473-3099(17)30592-3","article-title":"Effect of procalcitonin-guided antibiotic treatment on mortality in acute respiratory infections: a patient level meta-analysis","volume":"18","author":"Schuetz","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"10280","key":"2024081914141034000_CIT0017","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/S0140-6736(21)00313-5","article-title":"Discontinuing \u03b2-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial","volume":"397","author":"Dinh","year":"2021","journal-title":"Lancet"},{"issue":"5","key":"2024081914141034000_CIT0018","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1177\/10600280221121144","article-title":"Pharmacist-driven methicillin-resistant S. aureus polymerase chain reaction testing for pneumonia","volume":"57","author":"Marinucci","year":"2023","journal-title":"Ann Pharmacother"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxae072\/57110039\/zxae072.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/81\/Supplement_4\/S137\/58852162\/zxae072.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/81\/Supplement_4\/S137\/58852162\/zxae072.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T15:14:18Z","timestamp":1724080458000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/81\/Supplement_4\/S137\/7629945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,15]]},"references-count":18,"journal-issue":{"issue":"Supplement_4","published-online":{"date-parts":[[2024,3,15]]},"published-print":{"date-parts":[[2024,8,19]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxae072","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,9,1]]},"published":{"date-parts":[[2024,3,15]]}}}