Pioneering UK Study Reveals That Procalcitonin Test Does Not Shorten Intravenous Antibiotics for Hospitalized Children

A groundbreaking study published in The Lancet has shed light on the effectiveness of a widely used blood test called procalcitonin (PCT) in shortening the time children spend on intravenous antibiotics in hospitals. Despite promising previous analysis, the trial found that using PCT biomarker to guide treatment decisions did not reduce antibiotic duration when compared with usual care.

Conducted by leading UK universities and hospitals, including Lancaster University, the University of Liverpool, and Alder Hey Children's NHS Foundation Trust, among others, the 'Biomarker-guided duration of Antibiotic Treatment in Children Hospitalised with confirmed or suspected bacterial infection' (BATCH) trial enrolled nearly 2,000 children aged between 72 hours and 18 years with suspected bacterial infections.

The researchers aimed to tackle antibiotic overuse in hospitalised children and reduce the spread of antimicrobial resistance (AMR), one of the world's greatest public health challenges. Antibiotic overuse is a key driver of AMR, leading to longer hospital stays, higher healthcare costs, and increased mortality.

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

Lead researcher Céu Mateus from Lancaster University said: "Being involved in research that has the potential to make a real difference in the way health care is provided and improving the use of resources in hospitals is very rewarding."

The study highlights the need for effective strategies to combat antibiotic overuse, including robust Antimicrobial Stewardship (AMS) programmes, training and education for clinicians, and implementation research.

UK researchers emphasize that continuing to invest in AMS programmes and public health campaigns to reduce antibiotic misuse is crucial. While PCT-guided treatment showed no benefits in this trial, it could still play a role in specific situations with further refinement.

The study's findings provide valuable insights into the challenges of implementing new diagnostic tests in hospitals as the UK progresses its Five-Year Antimicrobial Resistance Strategy.