[Procalcitonin as biomarker for infections]

Area of Science:

• Infectious Diseases
• Clinical Biomarkers
• Critical Care Medicine

Background:

• Antibiotic resistance is a major global health threat, exacerbated by inappropriate antibiotic use in non-bacterial infections.
• Procalcitonin (PCT) is a biomarker investigated for guiding antibiotic therapy in bacterial infections.

Purpose of the Study:

• To review randomized trials on the utility of procalcitonin (PCT) biomarker for managing patients with suspected bacterial infections in emergency departments (ED) and intensive care units (IC).

Main Methods:

• Systematic review of randomized controlled trials (RCTs) evaluating procalcitonin (PCT) biomarker use.
• Analysis of clinical outcomes in patients with lower respiratory infections in the ED and patients in the IC.

Main Results:

• In ED patients with lower respiratory infections, low PCT levels allowed safe withholding or shortening of antibiotic treatment without affecting clinical outcomes.
• In IC patients, a decrease in PCT levels indicated readiness to discontinue antibiotics sooner, leading to reduced exposure.
• PCT-guided antibiotic management was associated with reduced antibiotic prescriptions and shorter treatment durations.

Conclusions:

• Initiating and discontinuing antibiotic therapy based on PCT levels in ED and IC patients is a safe and effective strategy.
• PCT-guided antibiotic use appears cost-saving and significantly reduces overall antibiotic consumption.
• This biomarker-based approach aids in combating worldwide antibiotic resistance by optimizing antibiotic stewardship.