Role of Procalcitonin in the Management of Infected Patients in the Intensive Care Unit

Infect Dis Clin North Am. 2017 Sep;31(3):435-453. doi: 10.1016/j.idc.2017.05.003.


The combination of molecular pathogen diagnostics and the biomarker procalcitonin (PCT) are changing the use of antimicrobials in patients admitted to critical care units with severe community-acquired pneumonia, possible septic shock, or other clinical syndromes. An elevated serum PCT level is good supportive evidence of a bacterial pneumonia, whereas a low serum PCT level virtually eliminates an etiologic role for bacteria even if the culture for a potential bacterial pathogen is positive. Serum PCT levels can be increased in any shocklike state; a low PCT level eliminates invasive bacterial infection as an etiology in more than 90% of patients.

Keywords: Antimicrobial stewardship; Community-acquired pneumonia; Multiplex PCR; Procalcitonin; Respiratory panel; Sepsis; Septic shock.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antimicrobial Stewardship
  • Biomarkers / blood
  • Calcitonin / blood*
  • Community-Acquired Infections / blood*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / etiology
  • Community-Acquired Infections / microbiology*
  • Humans
  • Intensive Care Units*
  • Molecular Diagnostic Techniques
  • Multiplex Polymerase Chain Reaction
  • Pneumonia, Bacterial / blood*
  • Pneumonia, Bacterial / diagnosis
  • Pneumonia, Bacterial / microbiology
  • Sepsis
  • Shock, Septic / blood
  • Shock, Septic / microbiology


  • Anti-Bacterial Agents
  • Biomarkers
  • Calcitonin