Guidelines
Procalcitonin (PCT) Testing

Procalcitonin (PCT) Testing

Clinical Considerations

PCT results should always be interpreted in the context of the clinical status of the patient

  • Decisions regarding antibiotic therapy should NOT be based solely on PCT concentrations
  • PCT should always be used in conjunction with clinical signs and symptoms of infection and other laboratory and diagnostic evidence
  • In cases where the laboratory results do not agree with the clinical picture or history, additional testing should be performed

Ordering

  • Ordering is limited to the following physician group subset:
    • Intensivists
    • Infectious Diseases Specialists
    • Antimicrobial Stewardship (ASP) Physicians
  • Severe trauma

  • Surgery

  • Cardiogenic shock

  • Burns, inhalation injury

  • Malaria

  • Systemic Vasculitis, esp. Kawasaki Disease, Granulamatosis with Polyanglitis, Goodpasture’s Disease, Adult Onset Stills Disease

  • End Stage Renal Disease (cut off of 0.5 μg/L suggested)

  • Treatment with agents which stimulate cytokines (OKT3), anti-lymphocyte globulins alemtuzumab, IL-2, granulocyte transfusion

  • Paraneoplastic syndromes due to medullary thyroid and small cell lung cancer

  • Localized infections

    • Osteomyelitis
    • Abscesses
    • Mediastinitis
    • Empyema
    • Infective Endocarditis
  • Mycoplasma Pneumonia

  • PCT checked too early