Biomarkers for antimicrobial stewardship: a reappraisal in COVID-19 times?
- PDF / 908,584 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 204 Views
RESEARCH LETTER
Open Access
Biomarkers for antimicrobial stewardship: a reappraisal in COVID-19 times? Miranda van Berkel1, Matthijs Kox2,3, Tim Frenzel2,3, Peter Pickkers2,3, Jeroen Schouten2,3* , on behalf of the RCI-COVID-19 study group
Keywords: COVID-19, Procalcitonin, Antimicrobial stewardship On initial presentation, differentiation between earlystage coronavirus disease 2019 (COVID-19) and classical bacterial community-acquired pneumonia can be challenging. Furthermore, COVID-19 patients may develop a hyperinflammatory phase later in their disease process, which is particularly difficult to distinguish from a secondary bacterial infection. As a consequence, 72% of COVID-19 patients receive empirical antibiotic therapy during hospital stay [1]. Antibiotic overuse undoubtedly leads to an exacerbation of another—slowly progressive—pandemic: antimicrobial resistance [2]. Procalcitonin (PCT) has proven useful in the early diagnosis of lower respiratory tract infections of bacterial origin [3]. Furthermore, in the ICU setting, serial measurement of PCT can safely guide the withdrawal of antibiotic therapy [4]. In patients with COVID-19, C-reactive protein (CRP) is usually increased on presentation while PCT is often
low [5]. PCT appears to increase in COVID patients with severe disease and/or in those presenting with secondary bacterial infections [6]. Longitudinal data on both biomarkers in COVID-19 infections are currently lacking. Also, it is unclear to what extent PCT and CRP predict the occurrence of secondary infections in these patients. Data from 66 COVID-19 ICU patients were recorded in the Good Clinical Practice (GCP)-compliant data management system Castor (Castor EDC, Amsterdam, The Netherlands). PCT was determined using the Elecsys BRAHMS procalcitonin assay (Thermo Fisher Scientific), whereas CRP was determined using an immunoturbidimetric assay, both on a Cobas 8000 immunoanalyzer (Roche Diagnostics). Secondary infection was defined as “any infectious episode” evidenced by the presence of positive cultures and time-stamped at the day the culture was performed. Infectious episodes were independ-
* Correspondence: [email protected] 2 Department of Intensive Care Medicine, Radboud University Medical Centre, Postbus 9101, 6500 HB Nijmegen, The Netherlands 3 Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If mat
Data Loading...
