A recent pragmatic, multicenter randomized controlled trial (BATCH) conducted across 15 hospitals in the UK has provided critical insights into the effectiveness of procalcitonin-guided algorithms in managing antibiotic treatment for children hospitalized with confirmed or suspected bacterial infections.
The study, involving 1,949 children, compared standard clinical care with procalcitonin-guided therapy to determine if the biomarker could safely reduce the duration of intravenous antibiotic treatment. The findings revealed that while procalcitonin-guided algorithms were non-inferior to usual care in terms of safety, they did not significantly reduce the duration of antibiotic therapy. Additionally, cost-effectiveness analysis indicated higher healthcare costs without substantial clinical benefits.
These results highlight that in settings with robust antimicrobial stewardship programs, the routine use of procalcitonin for guiding antibiotic duration may not offer additional benefits. The study underscores the importance of context-specific strategies in optimizing antibiotic stewardship, particularly in pediatric care.
