Interest of procalcitonin in the management of bacterial infections

Introduction. Procalcitonin (PCT), a protein of 116 amino acids, is the precursor of calcitonin. Calcitonin is a peptide hormone of 32 amino acids. Most calcitonin is produced in humans by the para-follicular cells (also known as C-cells) of the thyroid gland, and by the ultimo-branchial bodies in many other animal species. Procalcitonin is a biomarker that can be used to rationalize the duration of antibiotic therapy in certain infections, particularly bacterial ones. Objective. The aim of this study was to evaluate the value of procalcitonin as a prognostic marker and as a tool for guiding the duration of antibiotic therapy in the management of bacterial infections in inpatients and outpatients at the Cliniques Universitaires de Lubumbashi. Methodology. We conducted a longitudinal descriptive study. A total of 59 patients ranging in age from 0 to over 50 years, regardless of sex, were included in our study. The study was conducted over a six-month period from May to October 2023. We measured procalcitonin in all patients included in this study. Results. Elevated procalcitonin levels were observed with peaks above 20 ng/ml prior to antibiotic therapy. Escherichia coli was the germ most isolated from urine cultures, and the majority of patients included in this study had received cephalosporins and fluoroquinolones. Over 80% of patients had PCT, CRP and ultrasensitive CRP values between 0 - 1 (in ng/ml for PCT and mg/dl for CRP and ultrasensitive CRP) after antibiotic therapy. Conclusion. The procalcitonin assay, beyond its ability to differentiate bacterial infections from viral or inflammatory pathologies, can therefore be used to identify patients who do or do not require antibiotic treatment