ProACT (Procalcitonin Antibiotic Consensus Trial) is a new multicenter trial being launched to study if a new blood biomarker test can be used in clinics to determine the cause of lung infections in patients arriving at hospitals’ emergency departments (ED).
Patients arriving at the ED exhibiting symptoms such as cough and breathing difficulties may have a lung infection caused by bacteria or by a virus, or have other non-infectious causes for their symptoms such as chronic obstructive pulmonary disease, or even congestive heart failure. However, patients afflicted by these symptoms are usually prescribed antibiotics. The test will measure the levels of a protein – procalcitonin – that was previously linked to bacterial infections but absent from viral infections. If a lung infection can be determined to be the result of a virus, the overuse of antibiotics can be avoided.
As David T. Huang, M.D., M.P.H., associate professor of critical care medicine and emergency medicine, University of Pittsburgh School of Medicine explained, “Doctors prescribe antibiotics more often than they would like to because it can be really hard to tell if a patient has a lung infection or a non-infectious disease. Furthermore, viral infections look very much like bacterial infections, and X-rays typically cannot distinguish between the two. This study will examine whether a novel biomarker can help doctors make more informed decisions about using antibiotics.”
The new trial, funded by a grant from the National Institute of General Medical Sciences, part of the National Institutes of Health, will recruit patients diagnosed with a non-critical lung infection during their ED visit. The study will need to enroll more than 1,500 lung infected patients. Patients who agree to be part of the study, will then be randomly selected to receive standard care or the blood test. The test results are given in one hour and are delivered to the physician treating the patient. In case admission to the hospital is required, a follow-up measurement on procalcitonin levels will be administered to patients. Patients will also be called for a consultation within 30 days after leaving the hospital to assess their general clinical status.
Dr. Huang said added, “The final decision to use or not use antibiotics is up to the doctor, who also will be taking into account the patient’s medical history and other factors. My hope is that we’ll find that patient outcomes are as just as good, while the antibiotic use declines.”