Biomarkers in sepsis: can they help improve patient outcome?

Curr Opin Infect Dis. 2021 Apr 1;34(2):126-134. doi: 10.1097/QCO.0000000000000707.

Abstract

Purpose of review: Biomarkers, mainly procalcitonin, are commonly used in sepsis diagnosis, prognosis and treatment follow-up. This review summarizes the potential benefit of their use for the critically ill.

Recent findings: Increased clinical evidence from randomized clinical trials of biomarker-guided treatment suggests a trend for appropriate but short antimicrobial treatment for the critically ill. Procalcitonin (PCT) is the most studied biomarker; in the majority of randomized clinical trials, the use of a stopping rule of antibiotics on the day when PCT is below 80% from baseline or less than 0.5 ng/ml was proven effective to reduce length of antimicrobial treatment, antibiotic-associated adverse events and infectious complications like infections by multidrug-resistant organisms and Clostridium difficile. Survival benefit was also noted.

Summary: Biomarkers, mainly PCT, may help improve sepsis outcome by restriction of injudicious antimicrobial use.

Trial registration: ClinicalTrials.gov NCT03714841 NCT03717350.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Biomarkers / blood*
  • Critical Illness / therapy
  • Humans
  • Procalcitonin / blood*
  • Sepsis / blood
  • Sepsis / diagnosis*
  • Sepsis / drug therapy
  • Sepsis / microbiology

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • Procalcitonin

Associated data

  • ClinicalTrials.gov/NCT03714841
  • ClinicalTrials.gov/NCT03717350