The Effect of Repeated Versus Initial Procalcitonin Measurements on Diagnosis of Infection in the Intensive Care Setting: A Prospective Observational Study. (October 2019)

• Record Type: Journal Article
• Authors: Levin, Phillip D.; Cohen, Matan J.; Ohev-Zion, Eden; Tannus, Samer; Stohl, Sheldon; Avidan, Alexander; Cohen-Poraduso, Ronit; Moses, Allon E.; Sprung, Charles L.; Benenson, Shmuel
• Is Part Of: Anesthesia & analgesia. Volume 129:Number 4(2019)
• Publication Date: 2019-10
• Subjects: Anesthesiology -- Periodicals; Anesthesia; Anesthesiology; Analgesia; Analgesics; Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1213/ANE.0000000000003313
• Languages: English
• ISSNs: 0003-2999

Abstract

Abstract : Procalcitonin (PCT) measurement has been proposed to direct antibiotic use. We examined whether repeated PCT measurements (0, 6, and/or 12 hours) versus the initial measurement only (time 0) increased the sensitivity and specificity of PCT for diagnosing infection in intensive care unit patients. Infection was identified in 67/176 (38%) patients. The sensitivity of repeated versus the initial PCT measurement (with a cutoff value 0.5 ng/mL) was 52/67 (77%; 95% confidence interval [CI], 66%–87%) vs 46/67 (69%; 95% CI, 56%–79%; P = .04) and specificity 60/109 (55%; 95% CI, 45%–65%) vs 59/109 (54%; 95% CI, 44%–64%; P = 1.0). Repeat PCT evaluations over 12 hours did not provide a clinically significant improvement in diagnostic accuracy when compared to the initial single test.