{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T18:41:06Z","timestamp":1782412866883,"version":"3.54.5"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","award":["NIHR132254"],"award-info":[{"award-number":["NIHR132254"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Blood biomarkers have the potential to help identify COVID-19 patients with bacterial coinfection in whom antibiotics are indicated. During the COVID-19 pandemic, procalcitonin testing was widely introduced at hospitals in the UK to guide antibiotic prescribing. We have determined the impact of this on hospital-level antibiotic consumption.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective, controlled interrupted time series analysis of organization-level data describing antibiotic dispensing, hospital activity and procalcitonin testing for acute hospitals\/hospital trusts in England and Wales during the first wave of COVID-19 (24 February to 5 July 2020).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the main analysis of 105 hospitals in England, introduction of procalcitonin testing in emergency departments\/acute medical admission units was associated with a statistically significant decrease in total antibiotic use of \u22121.08 (95% CI: \u22121.81 to \u22120.36) DDDs of antibiotic per admission per week per trust. This effect was then lost at a rate of 0.05 (95% CI: 0.02\u20130.08) DDDs per admission per week. Similar results were found specifically for first-line antibiotics for community-acquired pneumonia and for COVID-19 admissions rather than all admissions. Introduction of procalcitonin in the ICU setting was not associated with any significant change in antibiotic use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>At hospitals where procalcitonin testing was introduced in emergency departments\/acute medical units this was associated with an initial, but unsustained, reduction in antibiotic use. Further research should establish the patient-level impact of procalcitonin testing in this population and understand its potential for clinical effectiveness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac017","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T12:09:11Z","timestamp":1643285351000},"page":"1189-1196","source":"Crossref","is-referenced-by-count":17,"title":["Impact of introducing procalcitonin testing on antibiotic usage in acute NHS hospitals during the first wave of COVID-19 in the UK: a controlled interrupted time series analysis of organization-level data"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-1124","authenticated-orcid":false,"given":"Martin J.","family":"Llewelyn","sequence":"first","affiliation":[{"name":"Global Health and Infectious Diseases, Brighton and Sussex Medical School, University of Sussex , Brighton, BN1 9PS, UK"},{"name":"Department of Microbiology and Infection, University Hospitals Sussex NHS Foundation Trust , Brighton, BN2 5BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3239-8415","authenticated-orcid":false,"given":"Detelina","family":"Grozeva","sequence":"additional","affiliation":[{"name":"Centre for Trials Research, Cardiff University , Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Howard","sequence":"additional","affiliation":[{"name":"School of Healthcare, University of Leeds , Leeds, LS2 9JT, UK"},{"name":"Pharmacy Department, Leeds Teaching Hospitals , Leeds, LS1 3EX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Euden","sequence":"additional","affiliation":[{"name":"Centre for Trials Research, Cardiff University , Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Gerver","sequence":"additional","affiliation":[{"name":"Division of Healthcare Associated Infections and Antimicrobial Resistance, National Infection Service, Public Health England , 61 Colindale Avenue, London, NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2838-6833","authenticated-orcid":false,"given":"Russell","family":"Hope","sequence":"additional","affiliation":[{"name":"Division of Healthcare Associated Infections and Antimicrobial Resistance, National Infection Service, Public Health England , 61 Colindale Avenue, London, NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Heginbothom","sequence":"additional","affiliation":[{"name":"Healthcare Associated Infection, Antimicrobial Resistance and Prescribing Programme, Public Health Wales , 2 Capital Quarter, Tyndall St, Cardiff, CF10 4BZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Powell","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Royal Cornwall Hospital Trust , Truro, TR1 3LJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Richman","sequence":"additional","affiliation":[{"name":"Rx-Info Ltd, Exeter Science Park , 6 Babbage Way, Exeter, EX5 2FN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominick","family":"Shaw","sequence":"additional","affiliation":[{"name":"NIHR Respiratory Biomedical Research Centre, University of Nottingham , Nottingham, NG5 1PB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Thomas-Jones","sequence":"additional","affiliation":[{"name":"Centre for Trials Research, Cardiff University , Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"West","sequence":"additional","affiliation":[{"name":"University of Leeds , Worsley Building, Clarendon Way, Leeds, LS2 9LU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enitan D.","family":"Carrol","sequence":"additional","affiliation":[{"name":"Department of Clinical Infection, Microbiology and Immunology, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences , Ronald Ross Building, 8 West Derby Street, Liverpool, L69 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Pallmann","sequence":"additional","affiliation":[{"name":"Centre for Trials Research, Cardiff University , Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0193-8677","authenticated-orcid":false,"given":"Jonathan A. 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