Procalcitonin testing combined with NEWS2 evaluation compared with usual care based on NEWS2 for identification of sepsis and antibiotic initiation in the emergency department in England and Wales (PR

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Procalcitonin testing combined with NEWS2 evaluation was compared to usual care based on NEWS2 for sepsis identification and antibiotic initiation in emergency departments in England and Wales.
The study was a multicentre, randomised, controlled, open-label, phase 3 trial named PRONTO.
Primary endpoints were intravenous antibiotic initiation at 3 hours (superiority) and 28-day mortality (non-inferiority).
No difference was found in antibiotic initiation between the procalcitonin-guided care group and the usual care group.
28-day mortality was lower in the procalcitonin-guided care group compared to the usual care group.
The procalcitonin test result was considered in clinical decision-making for 64.7% of participants in the procalcitonin-guided care group.
Adverse events were recorded, with a slightly higher percentage in the usual care group.
The study concluded that procalcitonin-guided care did not change antibiotic initiation but was associated with reduced mortality, warranting further research.

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