Impact of Procalcitonin-Guided Testing on Antibiotic Stewardship: A Retrospective Quality Improvement Study

Objectives: This quality improvement study aimed to evaluate the impact of implementing restrictions on procalcitonin (PCT) testing to enhance antibiotic stewardship in a hospital setting. Methods: A retrospective, single-phase analysis was conducted over a five-month period at Eastbourne District General Hospital, involving 66 patients admitted to acute medical wards who underwent PCT testing. Data were extracted from electronic hospital records, including e-search, PACS, Evolve, and microbiology department databases. The study examined the correlation between PCT levels and other clinical and inflammatory markers, including C-reactive protein (CRP), white cell count (WCC), neutrophils, National Early Warning Score 2 (NEWS2), and temperature. Results: Restricting PCT testing resulted in a 40% reduction in inappropriate test requests. The use of PCT-guided decision-making was associated with a shortened duration of antibiotic therapy for lower respiratory tract infections (3–5 days compared to the standard 7–10 days). Strong positive correlations were observed between PCT and CRP (r = 0.985), WCC (r = 0.993), neutrophils (r = 0.986), NEWS2 (r = 0.958), and temperature (r = 0.960), all statistically significant (p < 0.0001). Conclusions: Selective use of PCT testing can optimize antibiotic prescribing practices and support effective antimicrobial stewardship. Long-term success relies on guideline adherence, clinician education, and seamless integration of PCT protocols into electronic health systems.