Abstract
According to WHO, infectious diseases remain in the top 10 of the most common causes of death worldwide, leading to an excessive consumption of antibiotics, often unnecessarily. Antibiotic stewardship policy aims to identify an useful surrogate marker for the differential diagnosis of the bacterial infections from viral or fungal infections. The aims of this strategy is to restrict the prescriptions of antibiotics in order to reduce morbidity associated with excessive antibiotic treatment, decrease of bacterial resistance and optimize the costs of patient care. Procalcitonin (PCT) has emerged in the early ‘90s as a specific biomarker for bacterial infections. Many clinical studies have shown a correlation between the use of PCT as a diagnostic marker of bacterial sepsis and decrease antibiotic consumption, without a secondary increase in mortality. However, the PCT has a number of limitations regarding sensitivity and specificity. Thus, it may be increased in non-infectious diseases or it may remain at low levels in bacterial infections. Also, PCT cannot replace clinical evaluation and bacteriological tests in facing a patient with suspected infectious disease. This review aims to summarize the available informations so far about pathophysiological mechanisms, biological role and clinical utility of PCT in the diagnostic and treatment algorithm of bacterial infections.
Highlights
According to WHO, infectious diseases remain in the top 10 of the most common causes of death worldwide, leading to an excessive consumption of antibiotics, often unnecessarily
This review aims to summarize the available informations so far about pathophysiological mechanisms, biological role and clinical utility of PCT in the diagnostic and treatment algorithm of bacterial infections
Majoritatea datelor disponibile confirmă rolul PCT în ghidarea tratamentului antibiotic la pacienţii cu infecţii bacteriene de tract respirator inferior sau sepsis, în asociere cu alte teste bacteriologice
Summary
According to WHO, infectious diseases remain in the top 10 of the most common causes of death worldwide, leading to an excessive consumption of antibiotics, often unnecessarily. Declanşarea sintezei de PCT de către citokinele proinflamatorii explică valorile serice crescute ale acesteia în SRIS non-infecţios, însă la valori mai scăzute comparativ cu valorile întâlnite în sepsisul de cauză bacteriană [7,8,12]. Diagnosticul precoce al sepsisului este cu atât mai important la această categorie de pacienţi, din cauza mortalităţii crescute asociată cu întârzierea instituirii tratamentului antibiotic corect.
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