2008. Outcomes of Patients with Positive Procalcitonin Levels Who Do Not Receive Continued Antibiotics

Abstract

BackgroundProcalcitonin (PCT) is a biomarker used to direct continued use of antibiotic therapy in patients with sepsis and community-acquired pneumonia. There is a lack of data on outcomes of patients with a positive PCT who do not receive continued antibiotics. We compared outcomes in patients with positive PCT levels who received antibiotics <24 hours to those who received ≥ 24 hours.MethodsA single-center, retrospective study to compare outcomes of adult patients with positive PCT (>0.25 μg/L) levels based on antibiotic duration. A report of hospitalized patients from January to June 2018 was generated and screened for inclusion criteria. Data collection included demographics, microbiologic data, Charlson Weighted Index of Comorbidity (CWIC), ICU admission, length-of-stay (LOS), and in-hospital mortality. Continuous and categorical variables were analyzed using Student’s t-test and Chi-square, respectively.Results443 of 998 patients met the inclusion criteria. 113 patients (25.5%) received <24 hours of antibiotics (Group 1) and 330 patients (74.5%) received ≥ 24 hours (Group 2). Group 1 had a higher CWIC, lower mean PCT and were less likely to have positive cultures (see table). Mean LOS was significantly different between the groups. ICU admission and mortality were not found to be different between the groups. While Group 1 had higher rates of noninfectious causes of mortality and Group 2 had higher rates of infectious, the differences were not significant. Among patients who died in-hospital, 47.6% vs. 63.2% had acute or chronic renal failure in Group 1 vs. Group 2, respectively.ConclusionPatients with elevated PCT levels are a heterogenous group. There was no overall difference in mortality between the two groups indicating that the interpretation of positive PCT results was overall appropriate in this study. Clinicians need to consider noninfectious causes of elevated PCT when evaluating patients. Disclosures All authors: No reported disclosures.