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Summary of the benefits and challenges

Helen Pardoe summarises the benefits and challenges of using procalcitonin outside of the ICU.

Most patients treated with sepsis are outside the intensive therapy unit (ITU).

In the UK, PCT levels are recommended to be taken in the Emergency Department. This allows an early low result to not be mistaken for an overall low level and also is the most logistically feasible. CRP levels are taken routinely throughout the UK in EDs which balances the laboratory workload.

PCT acts as a baseline for antibiotic prescribing. CRP levels in fungal or viral sepsis remain higher for longer so don’t guide antibiotic usage. PCT should be used as a tool to support diagnosis and necessary clinical care should still be delivered to treat sepsis.

PCT can be used in the Sepsis 6 delivery, which mandates those with suspected sepsis are given antibiotics within the hour upon admission. Prolonged courses of broad-spectrum antibiotics can lead to unpleasant consequences for patients. So, using PCT to de-escalate antibiotic usage may improve patient care.

Outside of the ITU, protocols are more difficult to embed.

If Healthcare Professionals followed local antibiotic prescribing guidelines and best practice in prescribing, PCT may offer less to patient care. However, using PCT to guide antibiotic prescribing outside of the ITU currently has the potential to improve patient care and reduce costs.

A larger version of the process map for taking a blood test in the emergency department is available here or in the downloads section below.

Would PCT be useful in your setting? Let us know in the comments below.

References cited in the video have been provided as direct links in the see also section below.

This article is from the free online

Procalcitonin: PCT as a Biomarker for Antimicrobial Stewardship

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