Procalcitonin


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


Collection Instructions

Specimen:Blood
Optimal Volume:3.0 mL
Minimum\Peds Volume:1.0 mL
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, Fairview Southdale - FSH, Grand Itasca GICH, Infectious Diseases Diagnostic Lab-Micro (UMMC East Bank))


Interpretive

Critical Range:Greater than or equal to 10 ng/mL
Reference Range:

 

Interpretation

Recommendation

<0.05 ng/mL

Normal

Very low risk of bacterial 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 the correct clinical context.

·      Consider obtaining blood cultures or other relevant cultures.

·      Recheck PCT in 6-12 hrs to ensure baseline low level.

·      If repeat PCT is rising, consider early systemic infection and consider starting antibiotics.

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 were NOT started, recheck PCT in:

·         6-12 hours to re-evaluate need for antibiotics.

2.00-9.99 ng/mL

High risk for progression to severe sepsis.

·       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 <0.5.

≥ 10 ng/mL

Very high likelihood of severe sepsis 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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