157. A Survey of the Mid-South VA Healthcare Network on Ordering Practices and Interpretation of Procalcitonin


 
 
 Procalcitonin (PCT) is an inflammatory biomarker that can be helpful for early detection of certain types of infections and can be a useful tool to decrease unnecessary antibiotic (abx ) exposure. However, its use among clinicians remains variable. The aim of this study was to elucidate current practices at a selection of Veteran’s Administration medical centers.
 
 
 
 The VISN-9 Antimicrobial Stewardship Collaborative distributed a 15-question survey electronically to providers at all five VA medical centers in VISN-9 between 1/15/22 to 3/31/22 to clinicians practicing in the acute care, ICU and ED settings. Information on level of training, primary site as well as current practices and beliefs about PCT were collected. Responses were tabulated as percentages for this cross-sectional study.
 
 
 
 99 providers completed the survey with two centers comprising 83% of responses. 44% of respondents were attendings.
 The Figures illustrate some interesting variability in the use of PCT. Figure 1 reveals more than half of residents but less than a quarter of attendings ordered PCT on admission for patients with suspected infection. Figure 2 shows similar use of PCT by attendings and residents to initiate abx, however, residents used PCT much more than attendings to justify continuation of abx, and residents used PCT somewhat more than attendings to de-escalate abx. Only one clinician ordered PCT daily. Figure 3, ordering practices by disease state, shows similar trends between the two groups.
 44% of all respondents felt somewhat comfortable whereas 22% felt somewhat uncomfortable interpreting PCT results. Some of the interesting comments from respondents included: “PCT is “ordered too often and indiscriminately”; “I never know what to do with it”; and “I usually allow my patients to complete their abx courses rather than discontinuing abx earlier”.
 
 
 
 Using PCT to help guide abx use can help minimize unnecessary abx exposure which may help to stem the increase in antimicrobial resistance. This survey indicates that many clinicians are unsure of when to use PCT, how often to order it, and whether it is a reliable enough tool on which to base treatment decisions. Further education will be necessary to help inform best practices.
 
 
 
 All Authors: No reported disclosures.
