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Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
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Responsible Editor
Giuseppe Agosta

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Chiara Riva
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da A.M. Azzini

La procalcitonina in terapia intensiva: dubbi che rimangono?
Procalcitonin in intensive care: unresolved doubts
<p>Procalcitonin (PCT), a test marketed by some twenty years, is available virtually on all the platforms present in clinical laboratories of any size, even if its precise role is still debated. PCT is requested especially by intensive care units (ICU) and it has been included in algorithms to guide the administration of antibiotics (AB). However, several reports concluded that, despite a theoretical physio-pathological basis, there is no unambiguous evidence that the inclusion of PCT in algorithms is effective to guide AB treatment. In 2012 the Cochrane Collaboration concluded that &ldquo;Further high-quality research is needed to confirm the safety of this approach in intensive care. Moreover, future studies should also establish cost-effectiveness by considering country-specific costs of procalcitonin measurement and potential savings in consumption of antibiotics and other healthcare resources, as well as secondary cost savings due to lower risk of side effects and reduced antimicrobial resistance&rdquo;. In 2015, the National Institute for Clinical Heath Excellence concluded that the test is promising but there is still insufficient evidence to recommend its use to guide the AB treatment of sepsis in ICU. Recently, in a paper published in the Clinical Chemistry journal among the limiting factors preventing widespread use of PCT in sepsis and antibiotic stewardship it was included: the limited availability (and high cost) of PCT, the reluctance showed by clinicians to deescalate antibiotics based on PCT results and the uncertainty about the generalizability of previous studies results. The duration of therapy generally tends to be longer compared to what was recommended by guidelines, and PCT-guided antibiotic discontinuation may be of little benefit in hospitals where duration of therapy is already optimized.</p>
Biochimica Clinica ; 42(2) 146-151
Opinioni - Opinions