Clinical Usefulness of Procalcitonin as Guideline of Antibiotic Treatment in Children with Respiratory Tract Infection

Han Hyuk Lim; Hye Jin Kang; Eun Ae Yang; Jae Ho Lee

doi:10.7581/pard.2012.22.1.110

Journal List > Pediatr Allergy Respir Dis > v.22(1) > 1033162

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Lim, Kang, Yang, and Lee: Clinical Usefulness of Procalcitonin as Guideline of Antibiotic Treatment in Children with Respiratory Tract Infection

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(1): 110-115.

Published online: 31 March 2012

DOI: https://doi.org/10.7581/pard.2012.22.1.110

Clinical Usefulness of Procalcitonin as Guideline of Antibiotic Treatment in Children with Respiratory Tract Infection

Han Hyuk Lim, MD, Hye Jin Kang, MD, Eun Ae Yang, MD, Jae Ho Lee, MD, PhD

Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.

Corresponding author (immlee@cnu.ac.kr)

Received 10 February 2012 Revised 13 March 2012 Accepted 20 March 2012

Abstract

Purpose

Procalcitonin (PCT), a precursor of calcitonin, has been described as a biomarker of bacterial infection and inflammation. This study was performed to evaluate the clinical usefulness of PCT levels and to reduce the unnecessary usage of antibiotics in children with lower respiratory tract infection (RTI).

Methods

Eighty-eight children, with lower RTI, under the age of 5 years, who were admitted to Chungnam National University Hospital, between May 2010 and December 2010, were enrolled. White blood cell counts, erythrocyte sedimentation rate, C-reactive protein, and PCT were measured. Blood and sputum cultures were performed to identify the causative bacteria and reverse transcription-polymerase chain reaction for the viruses. Clinical features were reviewed, retrospectively.

Results

The mean participant age was 1.9±1.5 years. The cut-off value for serum PCT levels, which was derived from the receiver-operator characteristic curve, was 0.11 ng/mL. In 29 patients (33.0%) with low PCT levels (<0.11 ng/mL), antibiotic therapy showed no benefit for clinical and laboratory findings. However, in 59 patients (67.1%) with high PCT levels (≥0.11 ng/mL), hospitalization (P=0.005) and fever (P=0.054) exhibited a shorter duration, after antibiotic therapy.

Conclusion

A single initial serum PCT levels (≥0.11 ng/mL) may be clinically useful to give a guideline for antibiotic treatment in children with lower respiratory tract infection and to reduce the unnecessary usage of antibiotics.

Keywords: Procalcitonin, Inflammation, Respiratory tract infection, Antibiotics

Figures and Tables

Fig. 1

The-cut off point for serum procalcitonin levels in children with lower respiratory tract infection. A serum procalcitonin level of 0.11 ng/mL has 74.6% sensitivity and 52% specificity for antibiotic use. ROC, receiver operating characteristic.

Table 1

Clinical and Laboratory Differences according to Serum Procalcitonin Levels

Values are presented as median (range) or number (%).

WBC, white blood cell; ANC, absolute neutrophil count; CRP, C-reactive protein.

Table 2

Clinical and Laboratory Differences according to Antibiotic Treatment in the Group with Low and High Serum Procalcitonin Levels

Values are presented as median (range).

WBC, white blood cell; ANC, absolute neutrophil count; CRP, C-reactive protein.

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