Procalcitonin-guided antibiotic therapy in adult sepsis: A biochemical perspective from a retrospective cohort study

Procalcitonin (PCT), a biomarker closely associated with bacterial infections, has emerged as a valuable tool in guiding antibiotic therapy. In sepsis management, it may help optimise antibiotic use and improve clinical outcomes. This retrospective cohort study aimed to evaluate the effectiveness of PCT-guided antibiotic therapy in adult sepsis patients, with a particular focus on biochemical responses.

We retrospectively analysed medical records of 110 adult sepsis patients admitted between January 2019 and December 2023. Patients were allocated to either a standard antibiotic group (n = 53) or a PCT-guided antibiotic group (n = 57). Key variables included demographic data, treatment duration, infection control metrics, and white blood cell (WBC) count, C-reactive protein (CRP), and PCT levels, among others, before and after therapy.

Compared with the standard group, the PCT-guided group exhibited significantly greater reductions in WBC, CRP and PCT levels (P< 0.05), shorter antibiotic duration, fewer secondary infections, and improved antibiotic de-escalation rates. A higher complete response rate (17.54% vs. 3.77%) was observed in the PCT-guided group. No significant difference was found in 28-day mortality.

PCT-guided antibiotic therapy led to more favourable changes in key biochemical markers and clinical outcomes, supporting its role as a biomarker-driven approach to antibiotic optimisation in sepsis management.