COST ANALYSIS FOR USE OF PROCALCITONIN AND INFLAMMATORY MARKERS IN COVID-19 VENTILATOR-ASSOCIATED PNEUMONIA

Abstract

TYPE: Abstract TOPIC: Chest Infections PURPOSE: Procalcitonin has been used to differentiate between bacterial infections and other inflammatory processes in COVID-19. The goal of this study is to observe if procalcitonin use is associated with decreased duration of antibiotics and potential cost savings. Additionally, secondary objectives include if procalcitonin use is associated with ventilator changes, inflammatory markers, and mortality. METHODS: In this retrospective study, 287 patient records were selected based on the diagnosis of positive SARS-CoV-2 by PCR test and patients requiring mechanical ventilation. Lab values were obtained based on ventilator associated events (VAE) or sputum collections. RESULTS: There was no significant difference in those who received antibiotics between the procalcitonin cohort and non-procalcitonin cohort. The average duration of antibiotics was not statistically significant for vancomycin (2.2d v 1.8d), piperacillin-tazobactam (5.6d v 4d), azithromycin (2.7d v 2.5d), or meropenem (3d v 3.3d), between the procalcitonin and non-procalcitonin groups, respectively. Secondary outcomes were similarly not significant for ventilator changes and inflammatory markers. Lactic acid was lower in the procalcitonin group (1.8 v 3,1, p=0.01) along with overall 30-day mortality (45% v 76%, p=0.02). CONCLUSIONS: The use of procalcitonin did not have a significant correlation with duration of antibiotic use, ventilator changes, or inflammatory markers. Overall, the cost of inflammatory markers was approximated to be $377 daily, without reduction of antibiotic usage. CLINICAL IMPLICATIONS: The use of procalcitonin did not reduce antibiotic usage in the setting of COVID-19 ventilator-associated pneumonia and results in greater costs. DISCLOSURE: Nothing to declare. KEYWORD: procalcitonin