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Using Procalcitonin in Septic Shock to Guide Antibacterial Therapy
Shannon M Sullivan1, Kathryn T Von Rueden
1Shannon M. Sullivan, MS, RN, CRNP, is a graduate of the University of Maryland Baltimore, School of Nursing blended Adult-Gerontology Acute Care Nurse Practitioner/Clinical Nurse Specialist program. She is an Acute Care Nurse Practitioner at the R Adams Cowley Shock Trauma Center, University of Maryland Medical Center in Baltimore, Maryland, and a member of Sigma Theta Tau, AACN, Society of Critical Care Medicine, and the American Association of Nurse Practitioners. Kathryn T. Von Rueden, MS, RN, ACNS-BC, FCCM, is an associate professor, University of Maryland Baltimore, Adult-Gerontology Acute Care Nurse Practitioner/Clinical Nurse Specialist DNP program, with a trauma/critical care/ED specialty. She is an active member of AACN, Society of Critical Care Medicine, Society of Trauma Nurses, National Association of Clinical Nurse Specialists, and is a Fellow in the American College of Critical Care Medicine.
Abstract:
Over the last decade, the biomarkers procalcitonin and C-reactive protein have gained interest in sepsis research. Procalcitonin is a unique biomarker that is specific to bacterial infection and has demonstrated utility in the risk stratification of patients with potential life-threatening bacterial infections. In addition, procalcitonin has been documented as having a role in reducing the rate of unnecessary antibiotics while positively impacting antibiotic resistance rates and cost savings. The purposes of this review article are to discuss the clinical relevance of C-reactive protein and procalcitonin as diagnostic and prognostic markers for sepsis with a focus on the use of serial procalcitonin levels as a component of antibiotic stewardship programs. The federal government has recently become invested in combating the progression of antibiotic resistance; a 5-year national plan has been developed to address these concerns. Establishing a reliable antibiotic stewardship program is one of the goals of this national plan.
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