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Using Procalcitonin in Septic Shock to Guide Antibacterial Therapy

Sullivan, Shannon M. MS, RN, CRNP; Von Rueden, Kathryn T. MS, RN, ACNS-BC, FCCM

Dimensions of Critical Care Nursing: March/April 2016 - Volume 35 - Issue 2 - p 66–73
doi: 10.1097/DCC.0000000000000164

Over the last decade, the biomarkers procalcitonin and C-reactive protein have gained interest in sepsis research. Procalcitonin is a unique biomarker that is specific to bacterial infection and has demonstrated utility in the risk stratification of patients with potential life-threatening bacterial infections. In addition, procalcitonin has been documented as having a role in reducing the rate of unnecessary antibiotics while positively impacting antibiotic resistance rates and cost savings. The purposes of this review article are to discuss the clinical relevance of C-reactive protein and procalcitonin as diagnostic and prognostic markers for sepsis with a focus on the use of serial procalcitonin levels as a component of antibiotic stewardship programs. The federal government has recently become invested in combating the progression of antibiotic resistance; a 5-year national plan has been developed to address these concerns. Establishing a reliable antibiotic stewardship program is one of the goals of this national plan.

Shannon M. Sullivan, MS, RN, CRNP, is a graduate of the University of Maryland Baltimore, School of Nursing blended Adult-Gerontology Acute Care Nurse Practitioner/Clinical Nurse Specialist program. She is an Acute Care Nurse Practitioner at the R Adams Cowley Shock Trauma Center, University of Maryland Medical Center in Baltimore, Maryland, and a member of Sigma Theta Tau, AACN, Society of Critical Care Medicine, and the American Association of Nurse Practitioners.

Kathryn T. Von Rueden, MS, RN, ACNS-BC, FCCM, is an associate professor, University of Maryland Baltimore, Adult-Gerontology Acute Care Nurse Practitioner/Clinical Nurse Specialist DNP program, with a trauma/critical care/ED specialty. She is an active member of AACN, Society of Critical Care Medicine, Society of Trauma Nurses, National Association of Clinical Nurse Specialists, and is a Fellow in the American College of Critical Care Medicine.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Address correspondence and reprint requests to: Kathryn T. Von Rueden, MS, RN, ACNS-BC, FCCM, School of Nursing, University of Maryland Baltimore, 655 W. Lombard Street, Baltimore, MD 21201 (

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