Procalcitonin

A UK trial led by University of Manchester researchers showed a new biomarker testing protocol for sepsis can safely reduce antibiotic treatment duration by 10%, potentially saving costs and reducing antimicrobial resistance.

The article critiques Prof. Jean-Louis Vincent's 2010 opinion on abandoning RCTs in ICU, highlighting the flaws in critical care research, such as the misuse of biological plausibility and the lack of sound disease models. It argues that critical care researchers are not true scientists, as they fail to improve models after failed trials, instead focusing on augmenting analysis. The article also criticizes the misuse of SOFA scores in sepsis definitions and suggests a return to scientific principles in medicine.

A novel scoring model for gangrenous appendicitis (GPA) in adults was developed using clinical characteristics, lab tests, and abdominal CT results. Seven independent predictors were identified: WBC, lymphocyte, D-dimer, glucose, and albumin levels, plus appendix diameter and fecalith presence. The model demonstrated strong diagnostic accuracy for predicting gangrenous and perforated appendicitis, validated across different populations, and aims to guide treatment decisions, particularly exploring non-surgical options.

Ruud Duijkers discusses a randomized controlled trial comparing PCT or CRP-guided antimicrobial treatment with standard care for CAP, highlighting the need for safety studies on CRP algorithms. He foresees biomarkers streamlining antibiotic prescription protocols, addressing issues with current stewardship interventions and rapid microbial tests. Duijkers believes biomarkers can lead to individualized treatment protocols, akin to diagnosing pulmonary embolism with d-dimer.

Research on procalcitonin's role in diagnosing and monitoring infections, including tuberculosis, with studies highlighting its use in differentiating bacterial from viral infections and guiding antibiotic decisions.