Procalcitonin was introduced to management of hospital-acquired pneumonia/ventilatorassociated
pneumonia (HAP/VAP) by the American Thoracic Society/Infectious Disease Society of
America (ATS/IDSA), in its 2005 HAP guidelines. It was based on the assumption that positive
procalcitonin (PCT) results indicative of HAP/VAP of bacterial aetiology will prompt antibiotic
therapy, and improve clinical outcomes. Antibiotic stewardship by monitoring of PCT kinetics
resulted in shorter antibiotic treatment durations with early cessation of therapies. The diagnostic part
is no more recommended due to weak evidence from studies. Beyond diagnostic uses, some studies
have shown that positive PCT levels are associated with poorer clinical outcomes in HAP/VAP,
Healthcare-associated pneumonia and community-acquired pneumonia. The article will discuss the
diagnostic role briefly and mainly the role as a prognostic indicator in the management of HAP/VAP.
Keywords: Hospital acquired, mortality, pneumonia, procalcitonin, respiratory tract infection, ventilator associated pneumonia.
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