Avaliação da procalcitonina como tecnologia de saúde a ser incorporada em um hospital universitário para redução de tempo de tratamento com antimicrobianos
Série temática: Avaliação de Tecnologias em Saúde Hospitalar (ATS-H)
DOI:
https://doi.org/10.34019/1982-8047.2023.v49.43112Keywords:
Procalcitonin, Diagnostic techniques and procedures, Antimicrobial stewardship, Technology assessment, biomedicalAbstract
Introduction: The use of the procalcitonin (PCT) biomarker in a rationalized manner can contribute to reducing the excessive usage of antimicrobial, saving resources and improving patient care. Objective: To evaluate the effectiveness of PCT in reducing antimicrobial treatment time and the financial impact and feasibility of incorporating this technology based on simulated scenarios in a small and medium-complexity hospital. Material and Methods: Literature review, based on the Pubmed database followed by cost analysis in simulated scenarios with the incorporation of the PCT test. Randomized clinical trials and systematic reviews whose intervention consisted of the use of PCT to guide the duration of antimicrobial treatment were included. Data selection and extraction was carried out by four independent reviewers. The cost analysis was carried out through simulated scenarios with the ten antimicrobials with the greatest impact on the institution, based on data of costs actually disbursed. Results: The final analysis included 8 articles. PCT resulted in significant reduction of duration of antibiotic treatment, reduction in mortality, length of stay, adverse events and costs. The cost simulation demonstrated that the PCT scenario was more economical for the majority of antimicrobials analyzed, reaching savings up to R$567.86 per treatment, in the case of combined therapy with meropenem, vancomycin and polymyxin. Conclusion: PCT-guided therapy reduces treatment duration, hospitalization and mortality, presenting a considerable impact on reducing direct costs, making it feasible to incorporate it into the analyzed scenario.
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Copyright (c) 2024 Tatiane Garcia do Carmo Flausino, Maira Gabriela Perego, Renata Pedrolongo Basso Vanelli, Cristina Maria Nunes Cabral, Elaine Gomes da Silva, Gerhard da Paz Lauterbach, Bárbara Martins Lima
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