The potential of molecular diagnostics and serum procalcitonin levels to change the antibiotic management of community-acquired pneumonia.
Two diagnostic bundles were compared in 127 evaluable patients admitted with community-acquired pneumonia (CAP). Diagnostic modalities in all patients included cultures of sputum (if obtainable) and blood, urine for detection of the antigens of Streptococcus pneumoniae and Legionella pneumophila, and nasal swabs for PCR probes for S. pneumoniae and Staphylococcus aureus. At least one procalcitonin level was measured in all patients. For virus detection, patients were randomized to either a 5-virus, lab-generated PCR panel or the broader and faster FilmArray PCR panel. Overall, an etiologic diagnosis was established in 71% of the patients. A respiratory virus was detected in 39%. The potential for improved antibiotic stewardship was evident in 25 patients with only detectable respiratory virus and normal levels of PCT.
['Gilbert|David|D|', 'Gelfer|Gita|G|', 'Wang|Lian|L|', 'Myers|Jillian|J|', 'Bajema|Kristina|K|', 'Johnston|Michael|M|', 'Leggett|James|J|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000900:Anti-Bacterial Agents D000942:Antigens, Bacterial D001419:Bacteria D002116:Calcitonin D017714:Community-Acquired Infections D003955:Diagnostic Tests, Routine D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D025202:Molecular Diagnostic Techniques D009297:Nasal Mucosa D018410:Pneumonia, Bacterial D016133:Polymerase Chain Reaction D011897:Random Allocation D044967:Serum D013183:Sputum D016896:Treatment Outcome D014780:Viruses D055815:Young Adult
Molecular diagnostics Procalcitonin Community-acquired pneumonia Diagnostic bundles FilmArray