Open AccessProcalcitonin: friend or foe in the setting of antimicrobial therapy?
Author(s) -
Valeriu Gheorghiță,
Bucureşti Institutul Naţional de Boli Infecţioase „Prof. Dr. Matei Balş“,
Aida Răşcanu,
Bucureşti Spitalul Universitar de Urgenţă Militar Central „Dr. Carol Davila“
Publication year - 2015
Publication title -
romanian journal of infectious diseases
Language(s) - English
Resource type - Journals
eISSN - 2069-6051
pISSN - 1454-3389
DOI - 10.37897/rjid.2015.1.2
Subject(s) - procalcitonin , medicine , intensive care medicine , antibiotics , antibiotic resistance , sepsis , antimicrobial stewardship , disease , antimicrobial , medical prescription , infectious disease (medical specialty) , immunology , biology , microbiology and biotechnology , pharmacology
According to WHO, infectious diseases remain in the top 10 of the most common causes of death worldwide, leading to an excessive consumption of antibiotics, often unnecessarily. Antibiotic stewardship policy aims to identify an useful surrogate marker for the differential diagnosis of the bacterial infections from viral or fungal infections. The aims of this strategy is to restrict the prescriptions of antibiotics in order to reduce morbidity associated with excessive antibiotic treatment, decrease of bacterial resistance and optimize the costs of patient care. Procalcitonin (PCT) has emerged in the early ‘90s as a specific biomarker for bacterial infections. Many clinical studies have shown a correlation between the use of PCT as a diagnostic marker of bacterial sepsis and decrease antibiotic consumption, without a secondary increase in mortality. However, the PCT has a number of limitations regarding sensitivity and specificity. Thus, it may be increased in non-infectious diseases or it may remain at low levels in bacterial infections. Also, PCT cannot replace clinical evaluation and bacteriological tests in facing a patient with suspected infectious disease. This review aims to summarize the available informations so far about pathophysiological mechanisms, biological role and clinical utility of PCT in the diagnostic and treatment algorithm of bacterial infections.