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

  • New Technologies and Advances in Infections Prevention (A Marra, Section Editor)
  • Published:
Current Treatment Options in Infectious Diseases Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Intensive Care Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, 5th Floor, São Paulo, 05651-901, Brazil

    Fabrício Torres de Carvalho MD, Roberto Rabello Filho MD, Ary Serpa Neto MD, MSc, PhD & Rodrigo Octavio Deliberato MD, MSc, PhD

  2. Intensive Care, AC Camargo Cancer Center, São Paulo, Brazil

    Fabrício Torres de Carvalho MD

  3. Laboratory for Critical Care Research, Hospital Israelita Albert Einstein, São Paulo, Brazil

    Lucas Bulgarelli BSc & Rodrigo Octavio Deliberato MD, MSc, PhD

  4. Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Ary Serpa Neto MD, MSc, PhD

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  1. Fabrício Torres de Carvalho MD
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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.

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de Carvalho, F.T., Rabello Filho, R., Bulgarelli, L. et al. Procalcitonin as a Diagnostic, Therapeutic, and Prognostic Tool: a Critical Review. Curr Treat Options Infect Dis 11, 1–11 (2019). https://doi.org/10.1007/s40506-019-0178-z

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