Decreased antibiotic exposure using a procalcitonin protocol for respiratory infections and sepsis in US community hospitals (ProCommunity)

Figures & data

Figure 1. Algorithm Used for PCT Guidance among PCT Hospitals.

Table 1. Unadjusted differences and proportion of patients with blood culture testing before and after matching.

	Before Matching			After Matching
	PCT Cohort N = 2766	Control Cohort N = 7960	p-value^a	PCT Cohort N = 2424	Control Cohort N = 4848	p-value^a
Patient Characteristics
Age, mean (SD) [median]	66.8 (16.3) [69.0]	67.6 (16.4) [70.0]	.012*	68.1 (14.8) [70.0]	68.1 (14.8) [70.0]	.966
Male, n (%)	1294 (46.8)	3604 (45.3)	.171	1106 (45.6)	2212 (45.6)	–
Any blood culture test, n (%)	2371 (85.7)	5683 (71.4)	<.001*	2074 (85.6)	4145 (85.6)	–
Consult with ID specialist, n (%)	329 (11.1)	740 (9.3)	<.001*	283 (11.7)	440 (9.1)	<.001*
Outcomes
AB DOT (days), mean (SD) [median]	9.1 (7.0) [7.0]	8.4 (7.4) [6.0]	<.001*	9.1 (7.0) [7.0]	8.5 (7.6) [6.0]	<.001*
Length of hospital stay (days), mean (SD) [median]	6.4 (4.3) [5.0]	6.0 (4.3) [5.0]	<.001*	6.4 (4.3) [5.0]	6.0 (4.3) [5.0]	<.001*
Length of stay in the ICU (days), mean (SD) [median]	1.4 (3.2) [0.0]	1.1 (2.6) [0.0]	.255	1.2 (3.1) [0.0]	1.0 (2.5) [0.0]	.461
30-day readmission, n (%)	298 (10.8%)	825 (10.4%)	.545	265 (10.9%)	510 (10.5%)	.591
Mortality, n (%)	144 (5.2%)	336 (4.2%)	.031*	114 (4.7%)	209 (4.3%)	.444
Acute kidney injury, n (%)	821 (29.7%)	2004 (25.2%)	<.001*	729 (30.1%)	1248 (25.7%)	<.001*
Clostridioides difficile infection, n (%)	14 (0.5%)	48 (0.6%)	.563	12 (0.5%)	26 (0.5%)	.818

Abbreviations. AB, antibiotics; DOT. days of therapy; ICU. intensive care unit; ID. infectious diseases; PCT. procalcitonin; SD. standard deviation. *Significant at the 5% level.

^aUnadjusted differences between cohorts were calculated using the Wilcoxon rank-sum test for continuous outcomes and chi-square test for dichotomous outcomes.

Table 2. Multivariable outcomes results.

	Multivariable Results^a PCT Cohort vs. Control Cohort	95% CI	p-value
AB DOT (days)	AD: −1.47	(–2.72; −0.22)	.021*
Length of hospital stay (days)	AD: −0.14	(–0.83; 0.55)	.690
Length of stay in the ICU (days)	AD: 0.03	(–0.13; 0.18)	.740
30-day readmission	OR: 0.99	(0.77; 1.28)	.946
Mortality	OR: 1.26	(0.78; 2.05)	.341
Acute kidney injury	OR: 1.26	(1.01; 1.58)	.038*

Abbreviations. AD, adjusted difference; AB, antibiotics; CI, confidence interval; DOT, days of therapy; ICU, intensive care unit; OR, odds ratio; PCT, procalcitonin.

*Significant at the 5% level.

^aIn addition to the matching criteria, regressions adjusted for hospital characteristics (number of beds and whether facility was affiliated with an academic center), race (separate indicators for black or Hispanic), and payer type (Medicaid, self-pay/unknown). The odds ratio of developing hospital-onset Clostridioides difficile infection was not reported due to the low number of events.