Guidelines for the Use of Procalcitonin for Rational Use of Antibiotics

Abstract

How to cite this article: Khilnani GC, Tiwari P, Zirpe KG, Chaudhary D, Govil D, Dixit S, et al . Guidelines for the Use of Procalcitonin for Rational Use of Antibiotics. Indian J Crit Care Med 2022;26(S2):S77–S94.

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

“…Procalcitonin (PCT) may be useful to guide antibiotic therapy in the ICU. PCT-guided treatment can reduce the duration of therapy and length of hospital stay in adult critically ill patients with sepsis [ 243 , 244 ]. Based on apparent benefit and no obvious undesirable effects, the 2021 Surviving Sepsis Campaign guidelines suggest using PCT along with a clinical evaluation to decide when to discontinue antibiotics in adults with an initial diagnosis of sepsis or septic shock and adequate source control, if the optimal duration of therapy is unclear and if PCT is available [ 183 ].…”

Ten golden rules for optimal antibiotic use in hospitals: based on the publication statement of the International Network Group of the World Antimicrobial Resistance

“…Procalcitonin (PCT) may be useful for guiding antibiotic therapy in the intensive care unit. PKTguided treatment can reduce the duration of therapy and length of hospital stay in critically ill adult patients with sepsis [243,244]. Based on the clear benefit and lack of obvious adverse effects, the Surviving Sepsis 2021 guidelines suggest using PCT together with clinical assessment to decide when to stop antibiotics in adults with an initial diagnosis of sepsis or septic shock and an adequate source of control, if the optimal duration of therapy is not clear and PCT measurement is available [183].…”

A machine learning strategy to mitigate the inappropriateness of procalcitonin request in clinical practice

“…Additionally, some drugs, such as alemtuzumab or OKT3, could stimulate cytokine production leading to PCT synthesis. Finally, PCT is not routinely elevated in immunocompromised patients or with atypical bacterial infections [ 4 ].…”