Does using procalcitonin to guide my sepsis care lower my chance of dying?

Procalcitonin is a blood test that helps doctors tell if an infection is bacterial. Using procalcitonin to guide antibiotic decisions in sepsis care has been studied to see if it improves survival. The evidence suggests that procalcitonin-guided care can lower the risk of death, especially in the short term, while also reducing antibiotic use.

What the research says

A 2024 randomized trial found that procalcitonin-guided care in emergency departments for suspected sepsis did not change how quickly antibiotics were started, but it did lower 28-day mortality compared to usual care ⁶. Another trial in sepsis patients with lower respiratory tract infections, pyelonephritis, or bloodstream infections showed that procalcitonin-guided antibiotic discontinuation reduced 28-day mortality from 28.2% to 15.2% and also lowered long-term infection-related complications at 180 days ¹¹. A network meta-analysis of 18 studies in critically ill adults with sepsis confirmed that procalcitonin-guided strategies shorten antibiotic treatment by about 2 days without increasing mortality or recurrence ⁹. However, a Cochrane review of acute respiratory infections found that procalcitonin guidance reduced antibiotic use and mortality in some settings, but the evidence was less certain for sepsis specifically ¹⁰. Overall, the strongest evidence from recent sepsis-focused trials supports a mortality benefit with procalcitonin guidance.

What to ask your doctor

• Is procalcitonin testing available in this hospital for sepsis care?
• How would procalcitonin results be used to guide my antibiotic treatment?
• What are the potential benefits and risks of using procalcitonin guidance for my condition?
• Does procalcitonin guidance work differently for different types of infections?
• How does procalcitonin compare to other tests like C-reactive protein (CRP) for managing antibiotics?