Procalcitonin monitoring in paediatric outpatient parenteral antimicrobial therapy (OPAT). An evaluation of procalcitonin monitoring in home antimicrobial treatment of children
We know that children who need intravenous antibiotics can miss days at school and the treatment can sometimes disrupt family life. Children can require prolonged courses of intravenous antibiotics, either in the recovery phase from a serious bacterial infection or as part of the management of a long-term (chronic) condition, such as cystic fibrosis (CF). This often means they have to stay in hospital, or travel in and out of the hospital regularly. The paediatric Outpatient Parenteral Antimicrobial Therapy (pOPAT) service supports the delivery of home intravenous antibiotics. Treatment at home has many potential benefits including improving recovery and quality of life, reducing impacts on schooling and family finances. It should reduce the risk of catching further infections in hospital. In this study we are looking to investigate a rapid procalcitonin test for bacterial infection and see if it helps to individualise patient treatment. This blood test can help doctors monitor response to intravenous antibiotic treatment in children. The test will help doctors understand if the antibiotics are working properly to treat the infection. We also want to find out parents’ and children’s views on the experience of being monitored like this at home. There is a lot of data showing that children from deprived backgrounds are more likely to develop serious infections requiring intravenous antibiotics. There seems to be a preference for doctors treating serious infections, to keep children from disadvantaged populations in hospital for longer, as it gives them reassurance that they can monitor the child more closely for signs of relapse or complications. This project will evaluate if there is equal access in our pOPAT service, and if the rapid procalcitonin test at home can help to reduce any inequality.