A suddenly collapsed man

摘要

A more critical review of the literature indicates that the clinical synopsis by Sandifer and Jones1 misportrays procalcitonin's value by suggesting that its use may redute antibiotic exposure without affecting outcome. PCT is a biomarker and its measurement is proposed as a means to enhance clinical decision-making regarding when to start and stop antibiotics, and additionally, when to escalate or deescalate other management for critical care patients. For identification of occult bacterial infectioni in infants, a circumstance in which clinical evaluation alone is considered inadequate, a systematic review concluded that procalcitonin's performance characteristics 3re inferior to less expensive C-reactive protein.2 When the availability of procalcitonin was randomized in a study of young children with fever and no source, procalcitonin did not significantly affect rates of antibiotic use or hospitalization. However, had clinicians actually used suprathreshold levels (>0.5 ng/mL) to consistently direct antibiotic administration, antibiotic use would have increased by 24%, whereas 23% of children with a bacterial infection would have inappropriately not received treatment.