PURPOSE OF REVIEW: We review the advantages and drawbacks of biomarkers in the diagnostic and prognostic assessment of systemic infections. RECENT FINDINGS: Since the signs and symptoms of severe infections can be ambiguous, biomarkers provide a more reliable tool in ascertaining the presence of a relevant bacterial infection, its severity and treatment response. Procalcitonin and, to a lesser extent, C-reactive protein and interleukin-8 can improve the diagnostic assessment of infections and guide antibiotic therapy. Promising prognostic biomarkers include cortisol, proadrenomedullin, copeptin and natriuretic peptides. The strengths and weaknesses of biomarkers must be recognized in order to use them rationally and safely. Cutoff ranges of biomarkers must be chosen according to the specific clinical context and they should be used as a complementary tool, to reinforce the clinical diagnostic workup. Biomarkers cannot determine the causative organisms and associated patterns of antibiotic susceptibility. SUMMARY: If used in the proper setting, serial measurements of diagnostic biomarkers may allow treatments to be adjusted at an early stage in patients with severe infections. This may involve either intensifying treatment when infection levels stay high or avoiding unnecessary prolonged courses of antibiotics when levels rapidly decrease, thereby improving the allocation of healthcare resources.
PURPOSE OF REVIEW: We review the advantages and drawbacks of biomarkers in the diagnostic and prognostic assessment of systemic infections. RECENT FINDINGS: Since the signs and symptoms of severe infections can be ambiguous, biomarkers provide a more reliable tool in ascertaining the presence of a relevant bacterial infection, its severity and treatment response. Procalcitonin and, to a lesser extent, C-reactive protein and interleukin-8 can improve the diagnostic assessment of infections and guide antibiotic therapy. Promising prognostic biomarkers include cortisol, proadrenomedullin, copeptin and natriuretic peptides. The strengths and weaknesses of biomarkers must be recognized in order to use them rationally and safely. Cutoff ranges of biomarkers must be chosen according to the specific clinical context and they should be used as a complementary tool, to reinforce the clinical diagnostic workup. Biomarkers cannot determine the causative organisms and associated patterns of antibiotic susceptibility. SUMMARY: If used in the proper setting, serial measurements of diagnostic biomarkers may allow treatments to be adjusted at an early stage in patients with severe infections. This may involve either intensifying treatment when infection levels stay high or avoiding unnecessary prolonged courses of antibiotics when levels rapidly decrease, thereby improving the allocation of healthcare resources.
Authors: Seamus P Whelton; Probal Roy; Brad C Astor; Lin Zhang; Ron C Hoogeveen; Christie M Ballantyne; Josef Coresh Journal: Am J Epidemiol Date: 2013-09-10 Impact factor: 4.897
Authors: J Haeuptle; R Zaborsky; R Fiumefreddo; A Trampuz; I Steffen; R Frei; M Christ-Crain; B Müller; P Schuetz Journal: Eur J Clin Microbiol Infect Dis Date: 2008-08-02 Impact factor: 3.267
Authors: Markéta Marková; Helena Brodská; Karin Malíčková; Veronika Válková; Petr Cetkovský; Michal Kolář; Martin Haluzík Journal: Support Care Cancer Date: 2013-05-28 Impact factor: 3.603
Authors: Oleksa Rewa; John Muscedere; Steve Reynolds; Xuran Jiang; Daren K Heyland Journal: Can J Infect Dis Med Microbiol Date: 2012 Impact factor: 2.471