Biomarkers in sepsis: can they help improve patient outcome?

Kyriazopoulou, Evdoxia; Poulakou, Garyfallia; Giamarellos-Bourboulis, Evangelos J

PURPOSE OF REVIEW Biomarkers, mainly procalcitonin, are commonly used in sepsis diagnosis, prognosis and treatment follow-up. This review summarizes the potential benefit of their use for the critically ill. RECENT FINDINGS Increased clinical evidence from randomized clinical trials of biomarker-guided treatment suggests a trend for appropriate but short antimicrobial treatment for the critically ill. Procalcitonin (PCT) is the most studied biomarker; in the majority of randomized clinical trials, the use of a stopping rule of antibiotics on the day when PCT is below 80% from baseline or less than 0.5 ng/ml was proven effective to reduce length of antimicrobial treatment, antibiotic-associated adverse events and infectious complications like infections by multidrug-resistant organisms and Clostridium difficile. Survival benefit was also noted. SUMMARY Biomarkers, mainly PCT, may help improve sepsis outcome by restriction of injudicious antimicrobial use.