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Table 1 Overview of studies investigating the use of PCT in different types and sites of infection

From: Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future

Type of infection Study designs PCT cut-off (ug/L) Benefit of using PCT? Main conclusions Selected References
Abdominal Infections observational 0.25 ? PCT may help to exclude ischemia and necrosis in bowel obstruction [2932]
Arthritis observational 0.1-0.25 + PCT differentiates non-infectious (gout) arthritis from true infection [37, 38, 73]
Bacteremic infections observational 0.25 ++ Low PCT levels help to rule out bacteremic infections [14, 15, 74]
Blood stream infection (primary) observational 0.1 ++ PCT differentiates contamination from true infection [13]
Bronchitis RCT 0.1-0. 5 +++ PCT reduces antibiotic exposure in the ED without adverse outcomes [50, 52]
COPD exacerbation RCT 0.1-0. 5 +++ PCT reduces antibiotic exposure in the ED and hospital without adverse outcomes [5052]
Endocarditis observational 2.3 + PCT is an independent predictor for acute endocarditis with high diagnostic accuracy [27, 28]
Meningitis before-after 0.5 + PCT reduces antibiotic exposure during outbreak of viral meningitis [7577]
Neutropenia observational 0.1-0.5 + PCT is helpful at identifying neutropenic patients with systemic bacterial infection [3941]
Pancreatitis observational 0.25-0.5 ? PCT correlates with severity and extend of infected pancreatitis [33, 36]
Pneumonia RCT 0.1-0. 5; 80-90% +++ PCT reduces antibiotic exposure in the hospital without adverse outcomes [16, 50, 5255]
Postoperative fever observational 0.1-0.5 + PCT differentiates non-infectious fever from post-operative infections [78]
Postoperative Infections RCT 0.5-1.0; 75-85% ↓ ++ PCT reduces antibiotic exposure in the surgical ICU without adverse outcomes [64, 65]
Severe sepsis/Shock RCT 0.25-0.5; 80-90% ↓ +++ PCT reduces antibiotic exposure in the ICU without adverse outcomes [61, 62]
Upper respiratory tract infections RCT 0.1-0.25 ++ PCT reduces antibiotic exposure in primary care without adverse outcomes [58]
Urinary tract infections observational 0.25 + PCT correlates with severity of urinary tract infections [15, 26]
Ventilator-associated pneumonia RCT 0.1-0.25 ++ PCT reduces antibiotic exposure without adverse outcomes [62, 63]
  1. Abbreviations: COPD, chronic obstructive pulmonary disease; ED, Emergency department; PCT, procalcitonin; RCT, randomized-controlled trial. The level of evidence in favor or against PCT for each infection was rated by two of the coauthors (PS, WCA) independently and disagreements were resolved by consensus.
  2. + moderate evidence in favor of PCT; ++ good evidence in favor of PCT; +++ strong evidence in favor of PCT; ? evidence in favor or against the use of PCT still undefined