Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Limitations of PCT

May be Falsely Elevated in the Following

Newborns (<48-72hrs old)

Massive Stress

  • Trauma

  • Surgery

  • Cardiac shock

  • Burns

  • Pancreatitis

Treatment with agents which stimulate cytokines

  • OKT3

  • Anti-lymphocyte globulins

  • Alemtuzumab

  • IL-2

  • Granulocyte transfusion

Malaria and some fungal infections

Acute graft versus host disease

Medullary thyroid tumors and small cell lung CA

Significant renal compromise especially ESRD/hemodialysis

  • Baseline values in absence of infection can rise 1.5 μg/L in ESRD prior to initiation of dialysis

  • During regular hemodialysis, in absence of infection baseline values may be as high as 0.5 μg/L

May be Falsely Low in the Following

Site-specific bacterial disease, for example:

  • Skin abscess

  • Empyema

  • Chronic osteomyelitis

  • Mediatinitis

PCT does not increase in response to organism that lack a cell wall e.g. Mycoplasma or Chlamydophila

PCT drawn too early in course of the infection