Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract Infections

Li, Hui; Luo, Yi; Blackwell, Timothy S.; Xie, Canmao

doi:10.1128/aac.00335-11

Cited by 48 publications

(32 citation statements)

References 33 publications

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“…As PCT levels increase upon bacterial infection and decrease upon recovery, they can be used to guide antibiotic therapy in individual patients as a surrogate biomarker [25,26]. Highly sensitive PCT assays are needed to reliably diagnose CAP and non-CAP lower respiratory tract infections (RTIs) [1,17].…”

Section: Clinical Usefulness Of Pct In Infectious Diseasesmentioning

confidence: 99%

Procalcitonin as a biomarker of infectious diseases

Lee

2013

Korean J Intern Med

128

104

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Traditional biomarkers, including C-reactive protein, leukocytes, erythrocyte sedimentation rate, and clinical signs and symptoms, are not sufficiently sensitive or specific enough to guide treatment decisions in infectious febrile diseases. Procalcitonin (PCT) is synthesized by a large number of tissues and organs in response to invasion by pathogenic bacteria, fungi, and some parasites. A growing body of evidence supports the use of PCT as a marker to improve the diagnosis of bacterial infections and to guide antibiotic therapy. Clinically, PCT levels may help guide the need for empirical antibiotic therapy, source control for infections, and duration of antibiotic therapy. The aim of this review is to summarize the current evidence for PCT in different infections and clinical settings, and to discuss the reliability of this marker in order to provide physicians with an overview of the potential for PCT to guide antibiotic therapy.

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Section: Clinical Usefulness Of Pct In Infectious Diseasesmentioning

confidence: 99%

Procalcitonin as a biomarker of infectious diseases

Lee

2013

Korean J Intern Med

128

104

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“…It is important to prevent unnecessary use of antibiotics for the patients, to apply appropriate treatments and to reduce morbidities, mortalities and expenditures for care via performing differential diagnoses of these diseases (7, 8). …”

Section: Introductionmentioning

confidence: 99%

Procalcitonin and CRP as Biomarkers in Discrimination of Community-Acquired Pneumonia and Exacerbation of COPD

Çolak¹,

Yılmaz²,

Toprak³

et al. 2017

Journal of Medical Biochemistry

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SummaryBackgroundSerum procalcitonin (PCT) and C-reactive protein (CRP) are markers of systemic inflammation and bacterial infection. We aimed to compare the usefulness of procalcitonin and CRP in patients with community-acquired pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD).MethodsA total of 116 consecutive patients were included in the study: 76 with chronic obstructive pulmonary disease in group 1, and 40 with pneumonia in group 2.ResultsMedian serum CRP level was 44 mg/L in the COPD group and 132 mg/L in the pneumonia group. Median value of serum PCT was found to be 0.07 in the COPD group and 0.14 ng/mL in the pneumonia group. Serum PCT and CRP levels were significantly higher in the pneumonia group compared to the COPD group (p<0.001). The area under the ROC curve was 0.788 (CI: 0.704–0.872) for CRP and 0.699 (CI: 0.599–0.800) for procalcitonin to identify pneumonia.ConclusionsProcalcitonin and CRP levels were significantly higher in patients with community-acquired pneumonia presenting to the emergency department with indications for hospitalization than in patients with exacerbations of chronic obstructive pulmonary disease. Serum CRP and procalcitonin concentrations were strongly correlated. CRP might be a more valuable marker in these patients with lower respiratory tract infections.

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“…These antibiotic-resistant infections increase hospital length of stay, mortality, and hospital costs [41]. A meta-analysis published in 2011 with eight studies (3431 patients) showed a significant reduction in antibiotic prescription in the PCTguided antibiotic treatment groups [42]. However, one should keep in mind that all patients should be carefully and frequently reassessed to ensure that their clinical condition improves spontaneously in a clinically appropriate time.…”

Section: Discussionmentioning

confidence: 98%