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Guidelines for Using Serum Procalcitonin Concentration to Treat Sepsis

Purpose: To use the serum procalcitonin concentration to guide antibiotic therapy in a patient who is critically ill and septic.

Description

Nobre et al used the serum procalcitonin (PCT) to help guide antibiotic therapy for a septic patient. This can shorten the duration of antbiotic therapy and the hospital stay without affecting patient safety. The authors are from the University of Geneva.


 

Patient selection: critically ill and septic

 

Initial therapy: parenteral antibiotics

 

Parameters:

(1) documented bacteremia in blood cultures

(2) initial serum procalcitonin concentration in µg/L

(3) followup day of antibiotic therapy

(4) serum procalcitonin concentration on the followup day

(5) clinical evidence of continuing severe infection

 

Bacteremia

Initial PCT

Followup

Recommendation

absent

< 1 µg/L

< 0.1 µg/L on day 3

discontinue antibiotics if no evidence of severe infection

present

NA

see below

at least 5 days of antibiotic therapy

NA

>= 1 µg/L

< 0.25 µg/L on day 5

discontinue antibiotics if no evidence of severe infection

NA

>= 1 µg/L

ratio of day 5 to day 0 < 0.1

discontinue antibiotics if no evidence of severe infection

 

where:

• The ratio < 0.1 indicates a > 90% reduction.

• Procalcitonin was measured using the Kryptor PCT assay (Brahms AG)

 


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Specialty

Objective

ICD-10