Abstract

CARRILLO ESPER, Raúl  and  PEREZ CALATAYUD, Ángel. Procalcitonin as marker of infectious processes in surgery: Current concepts. Cir. gen [online]. 2013, vol.35, n.1, pp.49-55. ISSN 1405-0099.

Objective: To review current concepts related to procalcitonin (PCT) for the diagnosis and follow-up of infections. Setting: Intensive care unit of the Hospital Médica Sur in Mexico City. Design: Review of the literature. Material and methods: We performed literature mining, using as keywords: PCT, infection, surgery and antibiotics, in the following databases: Ovid, Springer, Sciencedirect, EbscoHost, and PubMed, to be able to respond to the following questions: How useful is PCT for the diagnosis of infection and sepsis in different surgical scenarios, what impact does it have as prognostic factor? Which guidelines have included PCT as part of the diagnostic algorithm and as a tool for the decision to start, down-scale, and suspend antibiotics? Results: Of the 31 articles included in this review, seven corresponded to meta-analysis, seven to systematic reviews, four to non-inferiority studies, four to cohort multicentric, longitudinal studies, four to observational studies, and five to case-control studies. Based on the reviewed literature, procalcitonin revealed to be a useful marker for the diagnoses of infections and sepsis, with a 75% sensitivity (95% IC 67-76), 80% specificity (95% IC 76-91), with an area below the curve of 0.78 (95% IC 0.73-0.83). Specificity increases to 93.7% (95% IC 0.85-0.97) with cut-off points above 2 ng/ml. PCT-guided antimicrobial therapy diminishes significantly the days of antibiotic exposure. Conclusions: Based on the scientific evidence, PCT has been positioned as a good biomarker for the diagnosis of bacterial infections and to decide on the duration of antimicrobial therapy.

Keywords : Procalcitonin; infection; surgery; antibiotics.