A promising blood test does not reduce the time children in hospital have antibiotics, according to a ground-breaking UK study.
Overuse of antibiotics is a key driver of antimicrobial resistance (AMR), one of the world’s greatest public health challenges. It is therefore essential to find ways to reduce their use.
Previous research had suggested a procalcitonin test (PCT) might be able to safely shorten the time children in hospital spend on intravenous (IV) antibiotics.
Now, a new study has shown PCT cannot do this, allowing researchers to rule it out and explore other promising avenues.
The findings are part of a major trial by leading UK universities and hospitals, including the University of Southampton and University Hospital Southampton (UHS).
The trial was supported locally by the NIHR Southampton Clinical Research Facility.
Researchers have published their findings today in the Lancet Child & Adolescent Health.
Safely cutting antibiotics
The study was led by the University of Liverpool. It was conducted across 15 hospitals, including in Southampton. Overall, nearly 2,000 children with suspected bacterial infections took part. Over 500 children were involved at UHS, making it the second highest recruiter in the UK.
The study formed part of the BATCH trial. This aims to tackle antibiotic overuse in hospitalised children to reduce AMR. It is the largest trial of its kind to evaluate PCT-guided antibiotic treatment in children.
Real-world conditions
The study found adding PCT to routine care did not reduce the duration of IV antibiotic use.
The test was safe but costed more than standard methods. Healthcare teams also faced challenges integrating it into their decision-making processes.
Professor Enitan Carrol at the University of Liverpool was the chief investigator for the study.
“We are pleased to have completed this large multi-centre trial in hospitalised children,” she said. “Whilst the study did not demonstrate benefit from the additional procalcitonin test, there is important learning for future biomarker-guided trials in the NHS.”
Informing future care
The UK-wide research team included Southampton’s Professor Saul Faust, Dr Katrina Cathie and Dr Sanjay Patel. Prof Faust is a theme lead for microbiology, immunology and infection at the NIHR Southampton Biomedical Research Centre.
Dr Cathie, a consultant paediatrician at UHS, said: “While PCT seemed promising, we’ve shown it does not reduce intravenous antibiotic use in real-world conditions. These findings will help inform future approaches to reduce antibiotic use in children and help tackle the global threat of AMR.”
The study was funded by the National Institute for Health and Care Research (NIHR).
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