• Amia Andrade, Heejung Bang, Katie Reddick, Bryan Villaseñor, Nam K Tran, and Larissa May.
• Department of Emergency Medicine, UC Davis Medical Center, 2315 Stockton Blvd, PSSB 2100, Sacramento, CA 95817, United States of America. Electronic address: anadrade@ucdavis.edu.
• Am J Emerg Med. 2023 Apr 1; 66: 146151146-151.

IntroductionAcute respiratory infections make up a sizable percentage of emergency department (ED) visits and many result in antibiotics being prescribed. Procalcitonin (PCT) has been found to reduce antibiotic use in both outpatient and critical care settings, yet remains underused in the ED. This study aimed to evaluate whether point of care molecular influenza and Respiratory Syncytial Virus (RSV) testing, PCT, and a pharmacist driven educational intervention in aggregate optimizes antibiotic and antiviral prescribing in the ED setting.MethodsA randomized trial of the Cobas Liat Flu/RSV Assay, procalcitonin, and the use of pharmacist-led education in patients 0-50 years of age being seen in the ED for Influenza Like Illness (ILI) or acute respiratory illness. The study enrolled 200 ED patients between March 2018 and April 2022.ResultsThere was little difference in antibiotic or antiviral prescribing between the intervention and control groups in this study (39%-32% = 7.0%, 95% CI: -6.2, 20.2, P = 0.30). However, a post-hoc analysis of the use of procalcitonin showed results were used as indicated in the ED (P = 0.001).ConclusionPCT can be used in both adult and pediatric populations to help guide the decision of whether to treat with antibiotics in the ED setting. Pharmacist guided education may not be a driving factor.Copyright © 2023. Published by Elsevier Inc.

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