The role of procalcitonin in respiratory infections

Accurate diagnosis, risk stratification, and decisions about the need for and optimal duration of antibiotic therapy are cornerstones of the management of patients with respiratory infections. A growing body of evidence supports the use of procalcitonin, a marker of bacterial infection, in addition to conventional clinical parameters to improve diagnostic and prognostic assessment in patients with suspicion of respiratory infections. In addition, several randomized controlled trials indicate that procalcitonin may be used for clinical decision making about initiation and optimal duration of antibiotic therapy. For patients with respiratory infections, procalcitonin-guided antibiotic therapy resulted in less antibiotic use without any apparent adverse patient outcome. For other infections outcome studies are currently lacking. This review summarizes the results of recent investigations of procalcitonin in respiratory infections to provide physicians an overview of the utility and limitations of procalcitonin when used for bedside decision making.