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How to use… Procalcitonin
Philip Robinson1, Surjo Kiran De2
1Department of Paediatrics, Royal London Hospital, London, UK.
Insights
Procalcitonin is a useful infection marker for diagnosing bacterial sepsis in children. While widely used globally, UK guidelines do not yet recommend its routine use in paediatric clinical practice.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Diagnostics
Background:
- Diagnosing bacterial infections in febrile children presents a significant clinical challenge.
- Novel molecular techniques have emerged, yet rapid and accurate diagnostic assays are still needed for timely clinical decisions.
- Procalcitonin is a recognized infection biomarker with potential utility in diagnosing and excluding invasive bacterial infections in neonates and children.
Purpose of the Study:
- To review the existing literature on procalcitonin measurement in paediatric clinical scenarios.
- To evaluate the role of procalcitonin in diagnosing bacterial infections in unwell or febrile children.
- To assess the potential of procalcitonin for guiding empirical antibiotic treatment decisions.
Main Methods:
- Literature review of studies on procalcitonin use in paediatric bacterial infection diagnosis.
- Analysis of procalcitonin performance in common paediatric clinical presentations.
- Examination of procalcitonin's role in differentiating bacterial from non-bacterial infections.
Main Results:
- Procalcitonin shows promise as a biomarker for bacterial infections in children.
- Its measurement can aid in the diagnosis and exclusion of serious bacterial infections.
- Evidence supports its use in guiding antibiotic therapy decisions in specific paediatric populations.
Conclusions:
- Procalcitonin measurement is a valuable tool in the diagnostic workup of suspected bacterial infections in children.
- Further research and guideline development are needed for its routine implementation in UK paediatric practice.
- Procalcitonin can assist clinicians in making informed decisions regarding empirical antibiotic use.
Abstract:
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children. Although enthusiastically adopted in many countries and institutions, national guidance in the UK does not yet support its routine use. This article reviews the relevant literature on the use of procalcitonin measurement in common paediatric clinical scenarios.
