Procalcitonin use in Acute Medicine in the United Kingdom: a survey of practice, barriers and facilitators

Introduction: Use of procalcitonin (PCT) across Acute Medical Units (AMUs) in the United Kingdom (UK) post-COVID-19 is not well understood. We aim to explore clinician knowledge and behaviours relating to PCT-guided antimicrobial decision making for patients managed in NHS AMUs across the UK.

Methods: A web-based survey was sent via email to members of the Society of Acute Medicine

Results: There were 342 individual responses from 133 organisations, of which half (52.6%) had access to PCT (62.8% organisations). Self-reported knowledge of PCT was rated adequate or good for most respondents (84.3%), despite the majority of respondents reporting non-availability or unawareness of local PCT guidance (66.2% organisations). The greatest influences of PCT use were previous experience, personal review of evidence, and local culture. A majority of respondents (115/211;54.5%) felt PCT often (≥40% of the time) had a role in guiding antimicrobial decision making in the AMU.

Conclusions: There is widespread variation in practice, driven in part by inconsistency around local guidelines and a lack of national guidance to inform the use of this biomarker. We recommend the development of national, evidence-based guidance around the use of PCT to ensure consistency of approach and high-quality care for patients with suspected infection.