The combination of lung ultrasound and procalcitonin has the potential to enhance pneumonia management

A recent study demonstrated that the combination of lung ultrasound (LUS) and procalcitonin (PCT) proved to be a safe approach for treating bacterial pneumonia (BP), as it avoided the use of radiation and did not result in any additional costs. This study’s findings were published in the European Journal of Medical Research.

In this blinded, randomized clinical trial, a total of 194 children under the age of 18 with suspected bacterial pneumonia (BP) were enrolled. Among them, 96 children were randomly assigned to the experimental group (EG) and 98 children to the control group (CG). The randomization was based on whether lung ultrasound (LUS) or chest X-ray (CXR) was performed as the initial imaging test. The patients were then classified into three groups: 1) those with LUS/CXR results not suggestive of BP and PCT levels below 1 ng/mL, for whom no antibiotics were recommended; 2) those with LUS/CXR results suggestive of BP, inspite of the PCT value, for whom antibiotics were recommended; and 3) those with LUS/CXR results not suggestive of BP but with PCT levels above 1 ng/mL, for whom antibiotics were also recommended.

Out of the 194 patients, the image test did not suggest the presence of BP in 75 individuals with a PCT level below 1 ng/ml. 29/52 in the experimental group and 11/23 in the control group did not receive antibiotics. The image test indicated the presence of BP in 101 patients. 34/34 patients in the experimental group and 57/67 patients in the control group were prescribed antibiotics. Notably, there were statistically significant differences between the groups when the PCT level was below 1 ng/ml (p = 0.01). In 18 patients, the image test did not suggest BP, but their PCT level was above 1 ng/ml, and all of them were administered antibiotics. Additionally, a total of 0.035 mSv radiation per patient was avoided, and there was a 77% reduction in CXR per patient. The use of LUS did not result in a significant increase in costs.

Thus, it can be concluded that the utilization of LUS in conjunction with PCT was demonstrated to be a reliable strategy in the treatment of BP, without the necessity of radiation exposure or incurring additional costs.