Procalcitonin | Spectrum

Note

Procalcitonin-guided therapy is effective in reducing unnecessary antibiotic use for non-bacterial pneumonia, with no adverse impact on mortality, length-of-stay, or readmission rates

Procalcitonin is a tool to support, not supplant, clinician judgment. Interpretation should be made in light of the clinical picture and severity of illness. Procalcitonin can be used in those on corticosteroids, but has not been validated in patients with higher degrees of immunosuppression

Procalcitonin Level

>0.5 µg/L

Diagnostic implications: Bacterial pneumonia very likely

Antimicrobial guidance: Antibiotics strongly encouraged

0.25-0.5 µg/L

Diagnostic implications: Bacterial pneumonia likely

Antimicrobial guidance: Antibiotics encouraged

0.1-0.25 µg/L

Diagnostic implications: Bacterial pneumonia unlikely

Antimicrobial guidance: Antibiotics discouraged

<0.1 µg/L

Diagnostic implications: Bacterial pneumonia very unlikely

Antimicrobial guidance: Antibiotics strongly discouraged

Follow-up Testing

Antibiotic therapy can be discontinued when procalcitonin drops to below 0.25 µg/L OR ≥80% decrease