Anesthesia Experts

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

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AUTHORS: Levin, Phillip D., MB BChir et al

Anesthesia & Analgesia: March 1, 2018 –
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.

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