Streamlining antibiotic therapy with procalcitonin protocols: consensus and controversies

Area of Science:

• Clinical diagnostics and biomarkers
• Infectious disease management
• Antimicrobial stewardship

Background:

• Procalcitonin (PCT) is a recognized biomarker for bacterial infection likelihood and severity.
• Acute respiratory infections are a leading cause of global antibiotic prescriptions.
• Current evidence supports PCT-guided therapy in community-acquired pneumonia, reducing antibiotic exposure.

Purpose of the Study:

• To review recent studies on procalcitonin (PCT) utility in various clinical settings.
• To provide an outlook on ongoing and future interventional trials involving PCT.
• To discuss the benefits and controversies of PCT measurement in infection management.

Main Methods:

• Review of recent clinical studies evaluating procalcitonin (PCT) for bacterial infection diagnosis and management.
• Analysis of data from PCT-guided antibiotic therapy algorithms versus standard care.
• Discussion of current and emerging procalcitonin assay technologies, including point-of-care testing.

Main Results:

• PCT-guided antibiotic therapy in respiratory infections reduced antibiotic exposure without compromising safety.
• Reduced antibiotic use leads to lower costs, fewer side effects, and decreased antimicrobial resistance.
• Controversy remains regarding PCT's benefit in intensive care unit sepsis and non-respiratory infections.

Conclusions:

• Procalcitonin (PCT) is a valuable biomarker for guiding antibiotic therapy, particularly in respiratory infections.
• Widespread availability of sensitive PCT assays supports its clinical application.
• Further research is needed to clarify PCT's role in specific patient populations like sepsis.