Use of infection biomarkers in the emergency department

Abstract

The use of infection biomarkers in the emergency department is discussed in terms of their possible contributions to diagnostic-prognostic uncertainties, appropriate antibiotic treatments, and triage and follow-up planning. Procalcitonin (PCT), C-reactive protein (CRP), proadrenomedullin (proADM), and presepsin are among the most discussed infection biomarkers for use in the emergency department. Due to the variable sensitivity results and cutoff values, there are insufficient data to recommend the widespread use of CRP and procalcitonin (PCT) for the diagnosis and prognosis of infection in the emergency department. However, these biomarkers can be used for appropriate antibiotic use in selected infection groups, such as community-acquired pneumonia, especially to reduce unnecessary antibiotic prescribing. With its prognostic superiority over other biomarkers and its contribution to prognostic score systems in community-acquired pneumonia (CAP), proADM can be used to predict hospitalization, preferably within the scope of clinical studies. Although presepsin has been shown to have some advantages over other biomarkers to rule out sepsis, there are insufficient data for its clinical use in the emergency department.

Severe Acute Bronchial Asthma with Sepsis: Determining the Status of Biomarkers in the Diagnosis of the Disease

“…Moreover, in reaction to an illness or damage, procalcitonin rises within 4 h, peaks at 6 h with an 8–24 h plateau, and then falls back to normal within 2–3 days. In contrast, CRP has an onset of 12–24 h, a plateau of 20–72 h, and a return to baseline of 3–7 days or more [ 114 , 115 ].…”

Research progress of biomarkers for prognosis of patients with acute post-traumatic sepsis

“…Studies have shown that the contribution of CRP use to mortality prediction ranges from 5.7% to 18.1% by assessing the prognostic role of CRP in patients with sepsis [20] . Although this study suggests that CRP use in patients diagnosed with infection provides prognostic benefits, other studies have suggested that a single serum CRP level lacks specificity, that acute rejection and surgery may also cause abnormal increases in serum CRP, and that serum CRP levels decline slowly after the cessation of inflammatory stimulation.…”

“…Although this study suggests that CRP use in patients diagnosed with infection provides prognostic benefits, other studies have suggested that a single serum CRP level lacks specificity, that acute rejection and surgery may also cause abnormal increases in serum CRP, and that serum CRP levels decline slowly after the cessation of inflammatory stimulation. Thus, the prognosis of the disease cannot be accurately assessed [20] .…”