Скачать или смотреть Procalcitonin for Suspected Pneumonia and Sepsis: Are you Interpreting it Incorrectly?

In medicine, nothing is black and white, we all know this. Somehow, however, we have forgotten this regarding Procalcitonin which many clinicians use to rule in or rule out infection. You can use PCT in pneumonia and sepsis, sometimes. When I was in training, I was taught that Procalcitonin helped to differentiate between bacterial and viral infections. That's why it was approved by the FDA and that's why we use it today. I have seen other clinicians and colleagues suspect infection on a patient, order a PCT, see that it's negative, and then feel good about everything going on. On the same token, I've seen patients with an elevated PCT who are completely asymptomatic be kept in the hospital for extra days to be "observed" to see whether they will present themselves with an infection within the next 24 hours. Unfortunately, many people have not read the most recent studies where you have to tease that a negative PCT does not completely rule out infection and vice versa. This study, with a bunch of limitations within it, opened my eyes to the fact that you can have a patient with community acquired pneumonia and a negative PCT. Game changer. I no longer use it to make me feel better inside. I only use it when it's elevated in the first place and I have a confirmed bacterial infection to help me deescalate antibiotics and I also use it to help me know whether source control has been achieved.

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