Serum Procalcitonin: A Component to Sepsis Diagnosis and its Role in Antibiotic Stewardship

Although it has not always been known as the same name, the clinical presentation and implications of sepsis have been described for centuries.1 There have been many revisions of the definition in an attempt to solidify the pathophysiology and narrow the treatment, but sepsis is broadly understood as the body’s over exaggerated, harmful immune response to an infection.1 Sepsis remains largely a clinical diagnosis and there is no single definitive test. In recent years, serum Procalcitonin has emerged as a biomarker and possible way to differentiate certain types of infection, specifically bacterial infection.2 The accuracy and usefulness of this serum test is still being studied in a variety of settings in the medical field. If proven helpful, Procalcitonin could have a vital role in the diagnosis and treatment path for patients with sepsis as well as an important role in antibiotic stewardship. This article will be referring to bacterial sepsis. Sepsis is a widely studied topic of medicine because it is very commonly seen and can have grave impacts on morbidity and mortality.3 It is now widely known that early resuscitation and empiric antibiotic initiation reduces mortality.4 The difficulty lies in the wide array of clinical presentations of patients with sepsis and making a definitive diagnosis in a timely manner for treatment purposes. Serum Procalcitonin has emerged as a possible adjunctive tool in the definition of sepsis, specifically in regards to appropriate antibiotic initiation and discontinuation.