PUAT facilitates de-escalation of broad-spectrum antimicrobials for community-acquired pneumonia

Key clinical point: Pneumococcal urinary antigen testing (PUAT) effectuated early de-escalation of broad-spectrum antibiotics among positive patients with community-acquired pneumonia (CAP) and thus should be widely performed to substantiate antimicrobial stewardship interventions.

Main finding: PUAT-positive patients showed a significantly shorter median (interquartile range) time to de-escalation vs. PUAT-negative patients (1 [0-2] days vs. 1 [1-2] days; P = .01) and a higher atypical (azithromycin or doxycycline) coverage discontinuation rate within 24 hours of PUAT (61.3% vs. 47.2%; P = .026), with no significant difference in methicillin-resistant Staphylococcus aureus agent discontinuation (P = .610) or antipseudomonal de-escalation (P = .895).

Study details: The data come from a retrospective chart review study including 910 adult patients who were hospitalized for CAP and, as part of the diagnostic procedure, underwent PUAT, which returned a positive result in 121 patients.

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Disclosures: The authors reported no financial support or conflict of interests.

Source: Greenfield A et al. Open Forum Infect Dis. 2021;ofab522 (Oct 22). Doi: 10.1093/ofid/ofab522.