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.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.