Usefulness Of Procalcitonin In Guiding Therapy Prior To Culture And Sensitivity Reports Antibiotic

Research Article
Indresh Kumar, Naveen Mohan, Gireesh Kumar, Sreekrishnan TP, Dhansekharan DS and Surg Cdr A S Chauhan
DOI: 
http://dx.doi.org/10.24327/ijrsr.2019.1006.3574
Subject: 
science
KeyWords: 
Procalcitonin, C - reactive protein, Systemic inflammatory response syndrome, antibiotics, sepsis
Abstract: 

Background: Procalcitonin (PCT) is currently the most studied infection biomarker and it’s blood levels seem to mirror the severity of illness and outcome. PCT is also widely used together with other biomarkers, such as white blood cells (WBC) count and C reactive protein (CRP) to guide antibiotic therapy. This study aims to verify the diagnostic and prognostic power of PCT to guide antibiotics therapy in the emergency department(ED), prior to obtaining culture and sensitivity reports, specifically in patients with suspected/proven sepsis. Objectives: To determine the usefulness of sepsis biomarkers procalcitonin in guiding antibiotic therapy prior to obtaining culture and sensitivity reports, specifically in patients presenting to the Emergency department with suspected/proven sepsis. Materials and Methods: PCT and Blood culture were simultaneously measured and compared in 113 patients who presented in emergency department with suspected/proven sepsis (2 positive criteria out of 4 for SIRS) according to the International consensus for sepsis. Other Necessary culture specimens were taken from appropriate suspected sources of infection, on case to case basis. Results: In culture positive 31 patients Procalcitonin levels were >0.2 in 20 patients, whereas CRP values were >10 in all the 31 patients. Conclusion: Antibiotic de-escalation strategy should not be employed solely based on procalcitonin and CRP levels. Lab culture reports and clinical judgement along with the sepsis biomarkers should also be taken into consideration, before de-escalation of antibiotics.