Prospective Observational Study to Determine Kinetics of Procalcitonin in Hospitalized Children Receiving Antibiotic The
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BRIEF REPORT
Prospective Observational Study to Determine Kinetics of Procalcitonin in Hospitalized Children Receiving Antibiotic Therapy for Non-Critical Acute Bacterial Infections Sophie E. Katz
. Jennifer Crook . Rendie McHenry .
Andras Szeles . Natasha Halasa . Ritu Banerjee
Received: September 7, 2020 / Accepted: October 8, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: The kinetics of procalcitonin in pediatric patients with non-critical acute bacterial infections receiving appropriate antibiotic therapy are not well described. Methods: We performed a single-center, prospective observational pilot study of children admitted to a tertiary care children’s hospital who were receiving antibiotics for treatment of a non-critical acute bacterial infection, and we prospectively measured serial procalcitonin levels daily for 4 days during hospitalization. Results: Among the 46 children with baseline procalcitonin levels enrolled in the study, procalcitonin kinetics followed a half-life of approximately 24 h in most patients. Procalcitonin declined faster than C-reactive protein over the first 48 h of appropriate antibiotic treatment. There was variation in biomarker levels among participants with the same S. E. Katz (&) R. McHenry N. Halasa R. Banerjee Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA e-mail: [email protected] J. Crook College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA A. Szeles Department of Medicine, University of Rochester, Rochester, NY, USA
infection type, especially in participants with bacteremia, musculoskeletal infection and skin/soft tissue infection. Conclusion: Utility of procalcitonin as a biomarker to follow every 24–48 h in non-critically ill children receiving antibiotic therapy for bacterial infections as an objective measure of clinical improvement is promising. Keywords: Kinetics; Pediatric; Procalcitonin Key Summary Points Among hospitalized children with serious bacterial infections, PCT declined faster than CRP over the first 48 h of appropriate antibiotic treatment. Proclacitonin kinetics followed a half-life of approximately 24 h in most pediatric patients. There was variation in biomarker levels among participants with the same infection type. The inclusion of single or serial procalcitonin values could strengthen pediatric prediction scoring systems.
Infect Dis Ther
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INTRODUCTION Procalcitonin (PCT) has been investigated as a biomarker for prediction of serious bacterial infection in febrile infants and critically ill adult patients with pneumonia and sepsis [1–8]. In adults with microbiologically confirmed bacterial infections, PCT levels have been shown to rise early in infection (2–4 h after a bacterial stimulus), peak after 12–24 h and
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