International Journal of Multidisciplinary Health Sciences and Research

Category: Original Article,      DOI: Recived: 10/04/2023, Accepted: 22/06/2023, Published online: 29/06/2023

Evaluation of Serum Procalcitonin Levels for Antibiotic Stewardship in Respiratory Tract Infections

Shivani Singh1*, Neha Mishra2

Background: Antibiotic resistance poses a significant global health challenge, particularly in respiratory tract infections (RTIs) where distinguishing between bacterial and viral etiologies remains crucial. This study evaluated serum procalcitonin (PCT) as a biomarker for guiding antibiotic stewardship in RTIs.

Methods: A 12-month prospective, observational study was conducted in a tertiary care hospital, enrolling 450 patients (225 per group) with various RTIs. PCT levels were measured using electrochemiluminescence immunoassay, with predefined cutoff values guiding antibiotic decisions. Outcomes were compared between PCT-guided and standard therapy groups.

Results: PCT demonstrated strong diagnostic utility with distinct thresholds: low levels (<0.1 μg/L) showed 86.5% negative predictive value for bacterial infection, while high levels (>0.5 μg/L) correlated strongly with bacterial etiology (91.4%). PCT-guided therapy reduced antibiotic duration significantly across all RTI types (mean reduction: CAP 2.9 days, AECOPD 2.9 days, upper RTI 3.1 days; p<0.001) while maintaining comparable clinical cure rates (PCT-guided: 89.3% vs. Standard: 88.0%, p=0.65). Protocol compliance improved from 82.3% to 91.8% over the study period.

Conclusion: PCT-guided antibiotic therapy demonstrated effectiveness in reducing antibiotic exposure while maintaining clinical outcomes across different RTI types. The clear correlation between PCT levels and bacterial infection provides a reliable framework for antimicrobial stewardship decisions, though clinical correlation remains essential, particularly in intermediate PCT ranges.