Benita Tujula1,2, Sari Hämäläinen3, Hannu Kokki2, Kari Pulkki4,5, Merja Kokki1,2. 1. Department of Anaesthesia and Intensive Care, Kuopio University Hospital, Kuopio, Finland. 2. School of Medicine, University of Eastern Finland, Kuopio, Finland. 3. Department of Medicine, Kuopio University Hospital, Kuopio, Finland. 4. Laboratory Division, Turku University Hospital, Turku, Finland. 5. Department of Clinical Chemistry, Faculty of Medicine, University of Turku, Turku, Finland.
Abstract
Background: Procalcitonin is a biomarker that can be used to diagnose bacterial infection and monitor treatment. Clinical practice guidelines are evidence-based recommendations by experts that aim to aid decision-making. In this systematic review, we searched for clinical practice guidelines and evaluated recommendations given regarding use of procalcitonin. Methods: Four biomedical databases (PubMed, Scopus, Cochrane Database and Web of Science) and various national medical sites were searched for clinical practice guidelines. Guidelines that mentioned procalcitonin were included in the review. Results: Seventeen guidelines were included. The earliest were published in 2009 and the latest in 2018. A majority (12/17) recommended use of procalcitonin or stated that it can be useful. One national guideline did not recommend procalcitonin, stating that there is no need for any biomarkers in diagnostics of community-acquired pneumonia in adults. Four guidelines stated no evidence to recommend or not recommend procalcitonin use. Thirteen of the guidelines commented on other concomitant or alternate biomarkers, mainly C-reactive protein. Five guidelines suggested decision limits for procalcitonin. None took a stand on how often procalcitonin should be analysed, and if it should be used as a single or as multiple measurements.Conclusions: One international and 11 national clinical practice guidelines endorse the use of procalcitonin in differential diagnosis of bacterial infections and/or to monitor antibiotic therapy. However, the evidence for or against the use of procalcitonin is weak.
Background: Procalcitonin is a biomarker that can be used to diagnose bacterial infection and monitor treatment. Clinical practice guidelines are evidence-based recommendations by experts that aim to aid decision-making. In this systematic review, we searched for clinical practice guidelines and evaluated recommendations given regarding use of procalcitonin. Methods: Four biomedical databases (PubMed, Scopus, Cochrane Database and Web of Science) and various national medical sites were searched for clinical practice guidelines. Guidelines that mentioned procalcitonin were included in the review. Results: Seventeen guidelines were included. The earliest were published in 2009 and the latest in 2018. A majority (12/17) recommended use of procalcitonin or stated that it can be useful. One national guideline did not recommend procalcitonin, stating that there is no need for any biomarkers in diagnostics of community-acquired pneumonia in adults. Four guidelines stated no evidence to recommend or not recommend procalcitonin use. Thirteen of the guidelines commented on other concomitant or alternate biomarkers, mainly C-reactive protein. Five guidelines suggested decision limits for procalcitonin. None took a stand on how often procalcitonin should be analysed, and if it should be used as a single or as multiple measurements.Conclusions: One international and 11 national clinical practice guidelines endorse the use of procalcitonin in differential diagnosis of bacterial infections and/or to monitor antibiotic therapy. However, the evidence for or against the use of procalcitonin is weak.
Entities:
Keywords:
C-reactive protein; Procalcitonin; clinical practice guideline
Authors: Lucyna Ścisło; Elżbieta Walewska; Iwona Bodys-Cupak; Agnieszka Gniadek; Maria Kózka Journal: Int J Environ Res Public Health Date: 2022-01-05 Impact factor: 3.390