Procalcitonin in VAP

Q: Procalcitonin has it's utility in Ventilator-Associated Pneumonia (VAP) for?  (select one)

A) Initiation of antibiotics 
B) Discontinuation of antibiotics


Answer:  B 

Unlike the utility of procalcitonin in making a decision for antibiotics initiation in suspected community-acquired pneumonia (CAP), it has practically no role in the initiation of antibiotics in VAP.1 But it certainly helps in determining when to stop antibiotics 2, as well as to act as a prognostic marker. 3, 4

#ventilators
#pulmonary
#infectiousdiseases


References:

1. Luyt CE, Combes A, Reynaud C, et al. Usefulness of procalcitonin for the diagnosis of ventilator-associated pneumonia. Intensive Care Med 2008; 34:1434.

2. Stolz D, Smyrnios N, Eggimann P, et al. Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomised study. Eur Respir J 2009; 34:1364.

3. Luyt CE, Guérin V, Combes A, et al. Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia. Am J Respir Crit Care Med 2005; 171:48.

4. Hillas G, Vassilakopoulos T, Plantza P, et al. C-reactive protein and procalcitonin as predictors of survival and septic shock in ventilator-associated pneumonia. Eur Respir J 2010; 35:805.