Guidelines
Procalcitonin Guidance for LRTI

Procalcitonin Guidance for LRTI

Procalcitonin Pathway

  • Active IV drug abuse
  • Severe Immunosuppression other than corticosteroid use
  • Life-threatening comorbidities
  • Hospital acquired pneumonia
  • Chronic infection necessitating antibiotic treatment

Use caution with CKD and AKI  patients as they tend to have falsely elevated PCT levels, increasing disease associated with progressively increased levels

  • LRTI admitted from the community or nursing home
  • LRTI includes CAP, AECOPD, Acute Bronchitis
  • Immediate life-threatening situation because rapid initiation of antibiotic therapy is of utmost importance
  • “High” severity CAP (by PSI score) or “most severe” COPD

Guideline for Starting Antibiotics

Antibiotics strongly discouraged

If initial antibiotics are withheld, a patient re-evaluation and repeat PCT level at 6-24 hours recommended if medical condition not improving (to detect late PCT rise)

Antibiotics discouraged

If initial antibiotics are withheld, a patient re-evaluation and repeat PCT level at 6-24 hours recommended if medical condition not improving (to detect late PCT rise)

Antibiotics encouraged

If initial antibiotics are withheld, a patient re-evaluation and repeat PCT level at 6-24 hours recommended if medical condition not improving (to detect late PCT rise)

Antibiotics strongly encouraged

If initial antibiotics are withheld, a patient re-evaluation and repeat PCT level at 6-24 hours recommended if medical condition not improving (to detect late PCT rise)

Guideline for Continuing or Stopping Antibiotics