Procalcitonin: In diagnosis of paediatric infections

Abstract

Although there are many diagnostic tests available for the diagnosis of infections, all have their own limitations with regard to time, sensitivity and specificity. As a result, there is an unnecessary and prolonged use of antibiotics, leading to multidrug resistance and antibiotic misuse. Increasing evidence supports the use of procalcitonin (PCT) in diagnosing bacterial infections as early as possible and titrating the antibiotics according to the dynamics of PCT value. PCT helps in the early diagnosis of the upper and lower respiratory tract infections, meningitis, post-operative cases, sepsis in intensive care units and the judicial use of antibiotics according to PCT algorithms. PCT is a reliable marker as compared to the other markers such as C-reactive protein, interleukin 1, 6, IF-gamma and tumour necrosis factor-alfa. PCT value is not affected by neutropenia, immunodeficiency disorders and with the use of steroid and non-steroid anti-inflammatory drugs. The aim of this review article is to summarise the current evidence for PCT in different infections and clinical settings and discusses the diagnostic and prognostic value of PCT in different types of infections, its limitations and the economics of usage of PCT.