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Procalcitonin as a Diagnostic, Therapeutic, and Prognostic Tool: a Critical Review

  • Fabrício Torres de CarvalhoEmail author
  • Roberto Rabello Filho
  • Lucas Bulgarelli
  • Ary Serpa Neto
  • Rodrigo Octavio Deliberato
New Technologies and Advances in Infections Prevention (A Marra, Section Editor)
  • 21 Downloads
Part of the following topical collections:
  1. Topical Collection on New Technologies and Advances in Infection Prevention

Abstract

Purpose of review

The target of this review is to highlight the current evidence about the utility of procalcitonin (PCT) in different clinical conditions, such as sepsis, respiratory tract infections, urinary tract infections, and bacteremias. The authors aim to discuss the potential benefits and limitations of this biomarker and propose how to safely individualize antibiotic treatment in clinical practice.

Recent findings

Many studies have demonstrated that PCT measurements increase within 6–12 h after bacterial invasion and correlate with disease severity and outcomes of patients with infection. Consequently, they can detect the presence and monitor the status of the bacterial infection, as an objectively and quickly available marker.

Summary

PCT-guided algorithms have positive effects in reducing antimicrobial use and mortality, especially in sepsis and respiratory tract infections. However, the adherence to PCT-guided strategies is variable and more studies are needed to validate its regular clinical use on other frequent sites of infections (e.g., skin/soft tissues, bone, CNS) and on specific populations such as immunocompromised patients, since it can be truly recognized as a tool able to reduce antibiotic exposure and costs, improving quality of medical assistance safely.

Keywords

Bacterial infections Diagnosis Biomarkers Procalcitonin Stewardship Antibiotic therapy 

Notes

Compliance with Ethical Standards

Conflict of Interest

Fabrício Torres de Carvalho declares that he has no conflict of interest. Roberto Rabello Filho declares that he has no conflict of interest. Lucas Bulgarelli declares that he has no conflict of interest. Ary Serpa Neto declares that he has no conflict of interest. Rodrigo Octavio Deliberato declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Fabrício Torres de Carvalho
    • 1
    • 2
    Email author
  • Roberto Rabello Filho
    • 1
  • Lucas Bulgarelli
    • 3
  • Ary Serpa Neto
    • 1
    • 4
  • Rodrigo Octavio Deliberato
    • 1
    • 3
  1. 1.Intensive Care UnitHospital Israelita Albert EinsteinSão PauloBrazil
  2. 2.Intensive CareAC Camargo Cancer CenterSão PauloBrazil
  3. 3.Laboratory for Critical Care ResearchHospital Israelita Albert EinsteinSão PauloBrazil
  4. 4.Department of Intensive Care, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands

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