Jones & Bartlett Learning Medicine Blog

    Antibiotic Stewardship with the Aid of Procalcitonin Measurements

    Posted by Joseph Esherick on Aug 23, 2011 4:37:43 PM

    Dr. Joseph Esherick Monthly Blog – August 2011

    There has been considerable interest in antibiotic stewardship programs over the past decade given the increase in drug-resistant bacteria.  The best way to combat the problem of drug-resistant bacteria is to develop systems which discourage the inappropriate initiation of antibiotics or the unnecessary prolongation of antibiotics.  The measurement of serum procalcitonin levels can aid sound clinical judgment for decisions regarding proper antibiotic use.

    Procalcitonin, the precursor peptide of calcitonin, is released in response to a body’s exposure to bacterial antigens or toxins.  Furthermore, the procalcitonin levels are suppressed by exposure to cytokines activated during viral infections, namely interferon gamma.  We know that the level of procalcitonin elevation is directly correlated with the severity of the bacterial infection.[1] In addition, procalcitonin levels rise within 6-12 hours after symptom onset of bacterial infections and decrease by about 50% per day once a bacterial infection is under control.[2]

    A number of randomized controlled trials have led to the development of procalcitonin guided clinical algorithms for various infections which have been used throughout Europe.  These protocols have led to a marked reduction in the use of antibiotics in adult patients treated in a variety of clinical settings with no increase in mortality or morbidity...

    Read More

    Topics: Dr. Joseph Esherick, Authors, Prescribing, viral infection, antibiotic, Hospital Medicine Blog, drug-resistant bacteria, hospital medicine

    Subscribe to Blog Email Updates

    Recent Posts

    Posts by Topic

    see all