Procalcitonin: Between evidence and critical issues.

Area of Science:

• Clinical diagnostics
• Infectious disease management
• Biomarker research

Background:

• Sepsis is a critical global health issue with diagnostic challenges.
• Procalcitonin (PCT) was initially considered a definitive sepsis biomarker.
• Current evidence shows limitations in PCT's diagnostic power for adult sepsis.

Purpose of the Study:

• To evaluate the diagnostic utility of procalcitonin (PCT) in sepsis.
• To assess PCT's role in differentiating systemic inflammatory response syndrome (SIRS) causes.
• To determine PCT's effectiveness in guiding antibiotic stewardship.

Main Methods:

• Literature review of procalcitonin (PCT) studies.
• Analysis of PCT's performance in various clinical settings.
• Evaluation of PCT's impact on antibiotic treatment decisions.

Main Results:

• PCT has limited ability to differentiate infectious vs. non-infectious SIRS in adults.
• PCT shows utility in diagnosing late-onset neonatal sepsis and bacterial meningitis.
• PCT can aid antibiotic stewardship, particularly in intensive care units.

Conclusions:

• Procalcitonin (PCT) is not a universally applicable sepsis diagnostic test.
• PCT is valuable for specific conditions like neonatal sepsis and guiding antibiotic therapy.
• Laboratory guidance is recommended for appropriate PCT test utilization across clinical wards.