The Effect of Repeated Versus Initial Procalcitonin Measurements on Diagnosis of Infection in the Intensive Care Setting: A Prospective Observational Study

Anesth Analg. 2019 Oct;129(4):e114-e117. doi: 10.1213/ANE.0000000000003313.

Abstract

Procalcitonin (PCT) measurement has been proposed to direct antibiotic use. We examined whether repeated PCT measurements (0, 6, and/or 12 hours) versus the initial measurement only (time 0) increased the sensitivity and specificity of PCT for diagnosing infection in intensive care unit patients. Infection was identified in 67/176 (38%) patients. The sensitivity of repeated versus the initial PCT measurement (with a cutoff value 0.5 ng/mL) was 52/67 (77%; 95% confidence interval [CI], 66%-87%) vs 46/67 (69%; 95% CI, 56%-79%; P = .04) and specificity 60/109 (55%; 95% CI, 45%-65%) vs 59/109 (54%; 95% CI, 44%-64%; P = 1.0). Repeat PCT evaluations over 12 hours did not provide a clinically significant improvement in diagnostic accuracy when compared to the initial single test.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Antimicrobial Stewardship
  • Bacterial Infections / blood
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology
  • Biomarkers / blood
  • Critical Care / methods*
  • Female
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Procalcitonin / blood*
  • Prospective Studies
  • Reproducibility of Results
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • Procalcitonin