Blood Test to Determine Lung Infection

A blood biomarker test is under investigation at the University of Pittsburgh Medical Center to determine if a specific bacteria is the cause of a patient’s lung infection.

The emergency department (ED) study is being led by Aaron Brown, MD, assistant professor of emergency medicine, and Franziska Jovin, MD, associate professor of medicine, both from the University of Pittsburgh School of Medicine. The study’s objective is to verify the proper antibiotics to prescribe on a wide scale, as well as to potentially reduce the overuse of drugs, which could lead to antibiotic-resistant strains of bacteria.

“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,” Brown said in a press release. “Also, 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 researchers will screen 1,500 lung infection patients using the Procalcitonin Antibiotic Consensus Trial (ProACT), which eventually will spread to 10 clinical testing sites across the country. The participants will be recruited if they have a lung infection diagnosis in the ED, and they will be randomly assigned to usual treatment or usual treatment plus a blood test to measure their procalcitonin levels, if they agree to join the study. A prior Swiss study has shown procalcitonin is high in bacterial infections and low with viral infections.

The researchers will then determine the participants’ study results and make a recommendation about proper antibiotics to the treating ED physician. If a patient is later admitted to the hospital, procalcitonin levels will be followed up on and periodically checked, with the results being reported to the treating physician. The investigators will call the participants 2 times within the 30 day ED visit to check their health status and their antibiotic use, if applicable.

“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,” David T. Huang, MD, MPH, associate professor of critical care medicine and emergency medicine, and the principal investigator of the study, continued in the press release. “My hope is that we’ll find that patient outcomes are as just as good, while antibiotic use declines.”