Hospital Best Practice: Include the PCT Test in Sepsis Program

Sepsis prevention and management should be a key component of a hospital's infection control program. CDC found the number of hospitalizations for sepsis more than doubled from 2000-2008. Both national institutions and patients support an increased focus on sepsis in hospitals. In September, the National Institutes of Health granted more than $8.4 million to the University of Pittsburgh Medical Center for a five-year study to develop protocols for diagnosing and treating sepsis. In addition, research by Partnership for Quality Care revealed that 84 percent of Americans surveyed believe reducing sepsis deaths and hospital-acquired infections should be a top priority in hospitals.

Some components of a strong sepsis program include a multidisciplinary leadership team, an antimicrobial plan and education of providers. Adding the procalcitonin, or PCT, test to a sepsis program may bolster a hospital's diagnostic abilities and avoid antibiotic overutilization. Sean-Xavier Neath, MD, an assistant clinical professor of medicine in the department of emergency medicine at the University of California San Diego Medical Center, discusses why the PCT test may strengthen hospitals' sepsis programs.

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PCT Test
The PCT test is a tool that uses the PCT biomarker to detect sepsis. Only recently introduced in the United States, the test has been used in Europe for about 15 years, according to Dr. Neath. The test detects sepsis earlier than other tests, giving patients a greater chance of recovering. "Procalcitonin is an essential tool that can play a role throughout a healthcare organization, from the emergency department to the ICU, to help improve survival in patients," Dr. Neath says. In addition to early detection, the PCT test delivers results more quickly — in about an hour — compared to the standard blood culture, which can take between 48-72 hours.

The PCT test may also have advantages for antibiotic control in hospitals. Dr. Neath says the current philosophy in an emergency department is to give a broad range of antibiotics to a patient suspected of having sepsis until the blood culture test reveals what the specific infection is. Using the PCT test, physicians can receive results faster and target antibiotics in a more controlled manner. "[It allows providers to] quickly remove antibiotics most likely to cause adverse effects, such as Clostridium difficile," Dr. Neath says.

The PCT test's faster detection of sepsis and reductions in unnecessary antibiotics may drive greater use of the test in hospitals. "Eventually PCT will become a standard of care in infectious disease management," Dr. Neath says. "[It's] not the 'be all and do all' — you'll still need blood cultures and someone determining the bacteria — but it [is] a good marker of severity and helps allocate resources [based on] what level of care patients need."

Related Articles on Sepsis:

New Test Can Detect, Prevent Spread of Sepsis Earlier
NIH Funding UPMC's 5-Year Study on Sepsis
Jury: Two Pennsylvania Physicians Acted Negligently in Patient's Sepsis-Related Death

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