Special reviews Procalcitonin in Critical Illness

Early procalcitonin kinetics and adequate empiric antibiotic therapy in critically ill

Pro/Con debate: Is procalcitonin useful for guiding antibiotic decision making in critically ill patients?

You are concerned about the escalating use of antibiotics in your intensive care unit (ICU). This has put a strain on the ICU budget and is possibly resulting in the emergence of resistant bacteria. You review the situation with your team and one suggestion is to consider using biomarkers such as procalcitonin to better guide appropriate antibiotic decision making.

Procalcitonin: seeking a niche

For over a decade there has been intense interest given to the role of procalcitonin in the diagnosis and management of sepsis in critically ill patients. Early opinions strongly supported the diagnostic role but data accumulating from numerous subsequent studies are less supportive, even when used in very selective settings. Although there remains sufficient reason to support the use of procal...

Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia.

We investigated the value of procalcitonin kinetics as a prognostic marker during ventilator-associated pneumonia (VAP). This prospective, observational study was conducted in a medical intensive care unit in a university hospital. All consecutive patients with microbiologically proven VAP who survived 3 days after its diagnosis were included and grouped according to clinical outcome: favorable...

Using Procalcitonin to Guide Antibiotic Therapy

Procalcitonin levels rise in response to systemic inflammation, especially of bacterial origin. Multiple randomized controlled trials have demonstrated that procalcitonin-based algorithms can safely reduce antibiotic use in 2 clinical scenarios. First, in stable, low-risk patients with respiratory infections, procalcitonin levels of <0.25 µg/L can guide the decision to withhold antibiotics or s...