Procalcitonin


Sunquest Code:PCAL  
Epic Code:LAB5727Epic Name:Procalcitonin
Synonyms:PCT
Methodology:ELISA
Turnaround Time:Performed and reported 24 hours/day.


Collection Instructions

Specimen:Blood
Optimal Volume:3.0 mL
Minimum\Peds Volume:1.0 mL
Container:Green (lithium heparin, gel)
Causes for Rejection:Hemolysis, icterus and lipemia, greater than moderate. Samples greater than 4 hours at room temperature. Samples greater than 48 hours old.


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 1.5 mL, 0.4 mL minimum. Samples are stable at room temperature for 4 hours and refrigerated for 48 hours. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Test Performed at or Referral Lab Chemistry  (Fairview Range - FRMC, UMMC-West Bank, UMMC-East Bank, Fairview Southdale - FSH)


Interpretive

Critical Range:Greater than or equal to 5.00 ng/mL
Reference Range:
  Interpretation Recommendations
<0.05 ng/mL Normal
  • Very low risk of bacerial
  • infection.
  • Strongly discourage
  • antibiotics.
0.05-0.24 ng/mL Low risk of systemic
infection. Local bacterial infection possible.
  • Assess other clinical features of infection.
  • Discourage antibiotics.
0.25-0.49 ng/mL Possible early systemic infection or localized infection
  • Encourage antibiotics only in correct clinical context.
  • Consider obtaining blood cultures or other relevant cultures.
  • Recheck PCT in 6-12 hours to ensure baseline low level.
  • If repeat PCT is rising, consider early systemic infection and consider starting antibotics.
0.50-1.99 ng/mL Moderate risk of systemic infection.
  • Recommend antibiotics
  • Evaluate culture results and clinical features to target antibacterial therapy.
  • Obtain blood cultures and other relevant cultures if not done.

If empiric antibiotics were started, recheck PCT in:
  • 2 days to guide antibiotic de-escalation.
  • Discontinue or de-escalate antibiotics when PCT concentration is <80% of peak or abs PCT <0.5.

If empiric antibiotics wre NOT started, recheck PCT in:
  • 6-12 hours to re-evaluate need for antibiotics.
 
2.00-9.99 g/mL High risk for progression to severe sepsis.
  • Strongly recommend initiating or continuing antibiotics.
  • Evaluate culature results and clinical features to target antibacterial therapy.
  • Obtain blood cultures and other relevant cultures if not done.
  • Repeat PCT in 2 days to guide antibiotic de-escalation.
  • Consider de-escalating antibiotics when PCT concentrtion is <80% or peak or abs PCT < 0.05.
≥ 10 ng/mL Very high likelihood of severe spesis or septic shock.
  • Strongly recommend initiating or continuing antibiotics.
  • Evaluate culture results and clinical features to target antibacterial therapy.
  • Obtain blood cultures and other relevant cultures if not done.
  • Repeat PCT in 2 days to guide antibiotic de-escalation.
  • Consider de-escalating antibiotics when PCT concentration is <80% of peak or abs PCT < 1.
   
Use:Useful in the diagnosis of systemic bacterial infection and sepsis and optimization of antibiotic therapy. Procalcitonin (PCT) is a calcitonin precursor produced during periods of heightened inflammation. PCT production is particularly pronounced in the presence of bacterial infection. High PCT levels might indicate severe infection, and low and/or decreasing levels might assist in deciding the most appropriate time to discontinue antimicrobial therapy.


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