Procalcitonin Test Does Not Reduce IV Antibiotic Treatment for Kids: Study Finds - Video

A new study found that using the procalcitonin biomarker to guide treatment decisions did not reduce antibiotic duration when compared to usual care for children.

The study, published in the Lancet Child & Adolescent Health, is part of the 'Biomarker-guided duration of Antibiotic Treatment in Children Hospitalised with confirmed or suspected bacterial infection' (BATCH) trial. BATCH is a national research trial to tackle antibiotic overuse in hospitalised children and reduce the spread of

antimicrobial resistance (AMR).

This study, conducted across 15 hospitals, enrolled nearly 2,000 children aged between 72 hours and 18 years with suspected bacterial infections.

The researchers found that adding the PCT test to routine care did not reduce the duration of IV antibiotic use. The test was safe but costlier than standard methods, and healthcare teams faced challenges integrating it into their decision-making processes.

The results highlight that introducing new tools like PCT tests alone isn't enough. Effective use requires:

Robust Antimicrobial Stewardship (AMS) programmes

Training and education for Clinicians

Future studies should identify barriers and facilitators to implementation to optimise fidelity of the intervention.

Better understanding of the complex interactions influencing whether/how/why clinicians act on information from diagnostic tests to make antibiotic prescribing decisions will improve trial intervention fidelity and facilitate implementation and adoption of tests shown to be effective.

The researchers note that although PCT-guided treatment didn't provide clear benefits in this trial, it could still play a role in specific situations with further refinement.

Chief investigator the University of Liverpool's Professor Enitan Carrol said: "We are pleased to have completed this large multi-centre trial in hospitalised children. Whilst the study did not demonstrate benefit from the additional procalcitonin test, there is important learning for future biomarker-guided trials in the NHS.

"The BATCH study was a pragmatic trial evaluating if the intervention works under real-world conditions where clinicians do not have to adhere to diagnostic algorithms about antibiotic discontinuation. Adherence to the algorithm was low in our study, and there were challenges in integrating the test into routine clinical workflows. The study highlights the importance of including behaviour change and implementation frameworks into pragmatic trial designs."