Utility of Serum Procalcitonin in Skin and Soft Tissue Infections

Abstract

Background Procalcitonin (PCT) has been studied as a biomarker to assist in the diagnosis and treatment of severe bacterial infections, mostly in the context of respiratory tract infections and severe sepsis, where it has been shown to reduce antimicrobial use without worsening clinical outcomes. The utility of PCT in guiding duration of antibiotic therapy in skin and soft tissue infections (SSTIs) has not been established. Our aim was to evaluate the relationship between the duration of intravenous antibiotic therapy for SSTIs and serum PCT; as well as the relationship between PCT and conventional markers of inflammation. Methods Serum PCT, leukocyte count, C-reactive protein and blood cultures laboratory, and body temperature were examined in 39 consecutive patients with SSTIs requiring inpatient intravenous antibiotic treatment. Results Thirty-nine consecutive inpatients presenting with SSTIs were evaluated. Procalcitonin values on admission correlated with duration of intravenous antibiotic therapy (Pearson correlation, 0.475; P = 0.002) and length of hospital stay (Pearson correlation, 0.534; P = 0.001). Peak serum PCT values also correlate with peak leukocyte count (Pearson correlation, 0.529; P = 0.001), peak C-reactive protein during hospitalization (Spearman correlation, 0.457; P = 0.003), and presence of Systemic Inflammatory Response Syndrome criteria on admission (P = 0.030). Conclusions Procalcitonin correlates with duration of intravenous antibiotic therapy in SSTIs; it may be a valuable adjunct in the initial diagnosis and management of antibiotic therapy in these infections.