We are currently trying to answer this these specific questions. There appears to be evidence re good de-escalation and benefit in the patients with pyrexia / elevated CRP but normal wcc in that a PCT of <0.25 reassures the clinician and discourages antibiotics and is it is <0.1 there is a good feeling of security in with-holding antibiotics.
Duncan [cid:[email protected]] DISCLAIMER: This email and any attachments are confidential and may be privileged or otherwise protected from disclosure. If you are not the intended recipient you must not copy this message or any attachment or disclose the contents to any other person, nor take any action in reliance of its contents: to do so is strictly prohibited and may be unlawful. If you have received this message in error please accept our apologies and contact us at the address below or by email at [email protected]<mailto:[email protected]> Any files attached to this email will have been checked by us with virus detection software before transmission. You should carry out your own virus checks before opening any attachment. UHCW (University Hospitals Coventry and Warwickshire NHS Trust) accepts no liability for any loss or damage which may be caused by software viruses. Any views or opinions expressed are those of the author and do not represent the views of the Trust unless explicitly stated. The information contained in this email may be subject to public disclosure under the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this email and your reply cannot be guaranteed. Address: UHCW NHS Trust, Executive suite, 3rd Floor Rotunda, University Hospital, Clifford Bridge Road, Coventry, CV2 2DX ________________________________ From: [email protected] [mailto:[email protected]] On Behalf Of Ron Daniels Sent: 14 November 2012 14:41 To: Thomas Morris Cc: [email protected] Subject: Re: [Sepsis Groups] Proacalcitonin Agree. There's minimal evidence imho that PCT is more specific than CRP, and still less that it is a more rapid marker of bacterial infection. To my mind, the manufacturers of the assay have sold this wrong. What I'd like to know from studies is how PCT modifies human behaviour in a) starting antimicrobials in non-critical cases and b) ceasing, de-escalating or changing antimicrobials as conditions progress. KR Ron On Tue, Nov 13, 2012 at 7:34 PM, Thomas Morris <[email protected]<mailto:[email protected]>> wrote: Hi Adrian Does procalcitonin really distinguish bacterial from other causes of SIRS/inflammation better than, say, CRP? Junior doctors in the UK are taught that essentially you can't ignore a CRP of 100mg/L or more without excluding bacterial infection (ie. it's usually bugs that would do that). Also, I think the half life is around about 24 - 36 hours. Sorry if this is a silly question! Tom Morris Infectious Diseases SpR, Leicester, UK On Fri, 9 Nov 2012 09:09:47 -0700 Adrian Verdin Z. <[email protected]<mailto:[email protected]>> wrote: Hello In one of the hospitals that I work we used a lot The level of procalcitonin in the blood stream of healthy individuals is below the limit of detection (10 pg/mL) of clinical assays.The level of procalcitonin raises in a response to a proinflammatory stimulus, especially of bacterias origin. In this case, it is produced mainly by the cells of the lung and the intestine. It does not raise significantly with viral or non-infectious inflammations. With the derangements that a severe infeccion with an associated systemic response brings, the blood levels of procalcitonin may rise to 100 ng/ml. In serum, procalcitonin has a half-life of 25 to 30 hours. Remarkably the high procalcitonin levels produced during infections are not followed by a parallel increase in calcitonin or serum calcium levels. Rewarts Dr. Adrián Verdín Z. Terapia intensiva Anestesia 614 159 3883 cell 614 1800 800 ext 16574 El 09/11/2012, a las 06:40, "patty jasper" <[email protected]<mailto:[email protected]>> escribió: Hi Everyone, We are just starting to use Procalcitonin at our facility and I was wondering what has been the general experience with it? Has anyone used it in the OB population? Has anyone used it in the pediatric population? Thanks Patty Garrity-Jasper, RN Clinical Educator Mercy General Sacramento, CA _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org -- Dr Ron Daniels CEO: Global Sepsis Alliance Chair: United Kingdom Sepsis Group Principal Trustee: U.K Sepsis Trust Founding Director: Survive Sepsis Fellow: NHS Improvement Faculty Suspect Sepsis: save someone's life today. Join us for World Sepsis Day on September 13th<http://www.globalsepsisalliance.org/> Twitter: @sepsisuk
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