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. 2020 Nov 26;58(12):1983-1991.
doi: 10.1515/cclm-2019-1122.

Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting

Chien-Chang Lee  1 , Andrea Lay Hoon Kwa  2   3 , Anucha Apisarnthanarak  4 , Jia-Yih Feng  5 , Eric Howard Gluck  6 , Akihiro Ito  7 , Anis Karuniawati  8 , Petrick Periyasamy  9 , Busadee Pratumvinit  10 , Jeetendra Sharma  11 , Rontgene Solante  12 , Subramanian Swaminathan  13 , Niraj Tyagi  14 , Dien Minh Vu  15 , Kapil Zirpe  16 , Philipp Schuetz  17   18
Affiliations
Free article

Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting

Chien-Chang Lee et al. Clin Chem Lab Med. .
Free article

Erratum in

Abstract

Introduction Recently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care. Methods Practical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific. Using a Delphi process, the group reached consensus on two PCT algorithms for the critically ill and the non-critically ill patient populations. Results The group agreed that the existing evidence for PCT-guided antibiotic stewardship in patients with acute respiratory infections and sepsis is generally valid also for Asia-Pacific countries, in regard to proposed PCT cut-offs, emphasis on diagnosis, prognosis and antibiotic stewardship, overruling criteria and inevitable adaptations to clinical settings. However, the group noted an insufficient database on patients with tropical diseases currently limiting the clinical utility in these patients. Also, due to lower resource availabilities, biomarker levels may be measured less frequently and only when changes in treatment are highly likely. Conclusions Use of PCT to guide antibiotic stewardship in conjunction with continuous education and regular feedback to all stakeholders has high potential to improve the utilization of antibiotic treatment also in Asia-Pacific countries. However, there is need for adaptations of existing algorithms due to differences in types of infections and routine clinical care. Further research is needed to understand the optimal use of PCT in patients with tropical diseases.

Keywords: Asia-Pacific; antibiotic stewardship; bacterial infection; biomarker; procalcitonin; respiratory tract infections; sepsis.

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References

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