What is the role of PCT measurement in the workup of bacterial sepsis?

Updated: Feb 05, 2019
  • Author: Amber Mahmood Bokhari, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Procalcitonin (PCT) is an acute-phase reactant that is elevated in severe bacterial infections. In most clinical assays, the reference range of PCT is below detectable. Measurement of PCT and C-reactive protein (CRP) at onset and on the fourth day of treatment can predict survival of patients with ventilator-associated pneumonia. A decrease in either one of these marker values predicts survival. [7]

A study from van Nieuwkoop et al examined the use of PCT levels in predicting bacteremia in a group of 581 patients, 136 of whom had bacteremia; PCT levels successfully identified 94-99% of the patients with bacteremia. [5]

Heyland et al, in a systematic review of the economic value of PCT-guided reduction in antibiotic use in intensive care, found that with hospital mortality and length of stay unchanged, PCT testing to reduce antibiotic treatment broke even when daily antibiotics cost about $150 in Canadian dollars. [6]

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