Department of Critical Care

Procalcitonin (PCT) Testing

Procalcitonin Testing (PCT)
PCT is a biomarker for the diagnosis of sepsis. At the same time, PCT has also been used to guide the initiation and discontinuation of antimicrobial therapy. The classic indications for PCT measurement are:
  • confirmation and/or exclusion of a diagnosis of sepsis
  • severity assessment and follow-up of systemic inflammation mainly induced by microbial infection
  • individual, patient-adapted guide of antimicrobial therapy and focused treatment. 

By using serially monitored PCT levels the duration and need of antibiotic therapy can be better adapted to the individual requirements of the patient. This individualized approach has been evaluated in various studies, and has been recommended to be implemented in concordance with an established antibiotic stewardship program. 

The International Guidelines for the Management of Severe Sepsis and Septic Shock (http://www.survivingsepsis.org) specifically support the use of procalcitonin testing. The guidelines encourage “the use of procalcitonin levels or similar biomarkers to assist clinicians in the discontinuation of empiric antibiotics in patients who initially appeared septic, but have no subsequent evidence of infection (grade 2C evidence)”.

References
Sager R, Kutz A, Mueller B, Schuetz P. Procalcitonin-guided diagnosis and antibiotic stewardship revisited. BMC medicine. 2017;15(1):15.

Ingber R, Alhammoud A, Murray D, Abraham R, Diebo B, et al. A Systematic Review and Meta-Analysis of Procalcitonin as a Marker of Postoperative Orthopedic Infections. Orthopedics. 2018 doi: 10.3928/01477447-20180409-07