Procalcitonin and Other Host-Response-Based Biomarkers for Evaluation of Infection and Guidance of Antimicrobial Treatment

Abstract

Sepsis, the body’s overwhelming response to systemic infections, has the potential to cause organ failure and is responsible for significant morbidity, mortality, and financial burden. Pathogens and their antigens stimulate pro- and anti-inflammatory mediators and immune markers that constitute the host defence and orchestrate leukocyte recruitment to the site of acute infection. Multiple immune and host-response markers have been studied in relation to sepsis for their diagnostic and/or prognostic utility. Recent studies have provided strong evidence that specific immune and host-response markers facilitate early recognition of sepsis, enable assessment of its severity, and provide guidance regarding therapeutic decisions in individual patients. This may allow for a transition from bundled, non-specific infection management involving protocols that combine several medical practices to more individualized management based on the clinical profile of each patient. Specifically, clinical trial data have shown that the host-response marker procalcitonin facilitates improved patient management given that its levels correlate with risk and severity of bacterial infections and can be used to guide therapeutic decisions pertaining to initiation and withdrawal of antimicrobial therapy. The use of procalcitonin and other host-response markers in conjunction with careful clinical assessment of a patient can improve management of infectious diseases by more appropriately tailoring the type and duration of treatment to address each patient’s unique therapeutic needs to ultimately achieve speedy resolution of the illness.