Pediatr Allergy Respir Dis.  2012 Mar;22(1):110-115.

Clinical Usefulness of Procalcitonin as Guideline of Antibiotic Treatment in Children with Respiratory Tract Infection

• Lim HH
• Kang HJ
• Yang EA
• Lee JH

Abstract

PURPOSE
Procalcitonin (PCT), a precursor of calcitonin, has been described as a biomarker of bacterial infection and inflammation. This study was performed to evaluate the clinical usefulness of PCT levels and to reduce the unnecessary usage of antibiotics in children with lower respiratory tract infection (RTI).
METHODS
Eighty-eight children, with lower RTI, under the age of 5 years, who were admitted to Chungnam National University Hospital, between May 2010 and December 2010, were enrolled. White blood cell counts, erythrocyte sedimentation rate, C-reactive protein, and PCT were measured. Blood and sputum cultures were performed to identify the causative bacteria and reverse transcription-polymerase chain reaction for the viruses. Clinical features were reviewed, retrospectively.
RESULTS
The mean participant age was 1.9+/-1.5 years. The cut-off value for serum PCT levels, which was derived from the receiver-operator characteristic curve, was 0.11 ng/mL. In 29 patients (33.0%) with low PCT levels (<0.11 ng/mL), antibiotic therapy showed no benefit for clinical and laboratory findings. However, in 59 patients (67.1%) with high PCT levels (> or =0.11 ng/mL), hospitalization (P=0.005) and fever (P=0.054) exhibited a shorter duration, after antibiotic therapy.
CONCLUSION
A single initial serum PCT levels (> or =0.11 ng/mL) may be clinically useful to give a guideline for antibiotic treatment in children with lower respiratory tract infection and to reduce the unnecessary usage of antibiotics.

Keyword

Procalcitonin; Inflammation; Respiratory tract infection; Antibiotics

MeSH Terms

Anti-Bacterial Agents
Bacteria
Bacterial Infections
Blood Sedimentation
C-Reactive Protein
Calcitonin
Child
Fever
Hospitalization
Humans
Inflammation
Leukocyte Count
Protein Precursors
Respiratory System
Respiratory Tract Infections
Sputum
Anti-Bacterial Agents
C-Reactive Protein
Calcitonin
Protein Precursors

Figure

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  Fig. 1 The-cut off point for serum procalcitonin levels in children with lower respiratory tract infection. A serum procalcitonin level of 0.11 ng/mL has 74.6% sensitivity and 52% specificity for antibiotic use. ROC, receiver operating characteristic.

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