Table 1

Overview of studies investigating the use of PCT in different types and sites of infection

Type of infection

Study designs

PCT cut-off (ug/L)

Benefit of using PCT?

Main conclusions

Selected References


Abdominal Infections

observational

0.25

?

PCT may help to exclude ischemia and necrosis in bowel obstruction

[29-32]

Arthritis

observational

0.1-0.25

+

PCT differentiates non-infectious (gout) arthritis from true infection

[37,38,73]

Bacteremic infections

observational

0.25

++

Low PCT levels help to rule out bacteremic infections

[14,15,74]

Blood stream infection (primary)

observational

0.1

++

PCT differentiates contamination from true infection

[13]

Bronchitis

RCT

0.1-0. 5

+++

PCT reduces antibiotic exposure in the ED without adverse outcomes

[50,52]

COPD exacerbation

RCT

0.1-0. 5

+++

PCT reduces antibiotic exposure in the ED and hospital without adverse outcomes

[50-52]

Endocarditis

observational

2.3

+

PCT is an independent predictor for acute endocarditis with high diagnostic accuracy

[27,28]

Meningitis

before-after

0.5

+

PCT reduces antibiotic exposure during outbreak of viral meningitis

[75-77]

Neutropenia

observational

0.1-0.5

+

PCT is helpful at identifying neutropenic patients with systemic bacterial infection

[39-41]

Pancreatitis

observational

0.25-0.5

?

PCT correlates with severity and extend of infected pancreatitis

[33,36]

Pneumonia

RCT

0.1-0. 5; 80-90%

+++

PCT reduces antibiotic exposure in the hospital without adverse outcomes

[16,50,52-55]

Postoperative fever

observational

0.1-0.5

+

PCT differentiates non-infectious fever from post-operative infections

[78]

Postoperative Infections

RCT

0.5-1.0; 75-85% ↓

++

PCT reduces antibiotic exposure in the surgical ICU without adverse outcomes

[64,65]

Severe sepsis/Shock

RCT

0.25-0.5; 80-90% ↓

+++

PCT reduces antibiotic exposure in the ICU without adverse outcomes

[61,62]

Upper respiratory tract infections

RCT

0.1-0.25

++

PCT reduces antibiotic exposure in primary care without adverse outcomes

[58]

Urinary tract infections

observational

0.25

+

PCT correlates with severity of urinary tract infections

[15,26]

Ventilator-associated pneumonia

RCT

0.1-0.25

++

PCT reduces antibiotic exposure without adverse outcomes

[62,63]


Abbreviations: COPD, chronic obstructive pulmonary disease; ED, Emergency department; PCT, procalcitonin; RCT, randomized-controlled trial. The level of evidence in favor or against PCT for each infection was rated by two of the coauthors (PS, WCA) independently and disagreements were resolved by consensus.

+ moderate evidence in favor of PCT; ++ good evidence in favor of PCT; +++ strong evidence in favor of PCT; ? evidence in favor or against the use of PCT still undefined

Schuetz et al. BMC Medicine 2011 9:107   doi:10.1186/1741-7015-9-107

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