Effectiveness of Adherence to Procalcitonin-Guided Antibiotic Protocol in Patients with Severe Sepsis

Background: The misuse of antibiotic therapies in hospitalized sepsis patients increases hospital length of stay and antimicrobial resistance. Procalcitonin (PCT) is a bacterial infection biomarker that can guide doctors in their decisions about whether to continue antibiotic therapy. The study aimed to compare hospital length of stay and duration of antibiotic therapy in patients managed with PCT decision protocols against comparable patients managed with standard care without PCT. Method: A randomized controlled trial was conducted in the Department of Medicine, MTI/Khyber Teaching Hospital, Peshawar, over six months. A total of 104 patients with severe sepsis were reviewed and randomized into two equal groups. PCT-guided antibiotic therapy was given to Group A patients while Group B patients received standard treatment without PCT. Patients were followed to discharge. Outcomes assessed were hospital length of stay and duration of antibiotic therapy. Data was analyzed using SPSS version 25, with a p ≤ 0.05 considered statistically significant. Results: The mean length of hospital stay was shorter in the PCT-guided group (14.2 ± 4.6 days) than the standard group (18.1 ± 5.3 days; p = 0.0001). The mean length of antibiotic therapy was also reduced in Group A (7.9 ± 2.3 days) versus Group B (11.6 ± 3.1 days; p = 0.0001). Conclusion: PCT-guided antibiotic protocol significantly reduces antibiotic exposure in addition to hospital stay for patients who present with severe sepsis. As a result, this treatment fostered antimicrobial stewardship and positively impacted clinical outcomes.