Table 1 Procalcitonin-based algorithm to guide antimicrobial use in acute pancreatitis
Evaluation only after enrolment at time of admission to hospital | ||
|---|---|---|
PCT result | < 1.0 μg/L | ≥ 1.0 μg/L |
|
| |
Recommendation on antibiotic use | Do not start antibiotics Stop antibiotics in patients already on antimicrobial therapy | Antibiotic intervention (follow Trust guidelines for prophylaxis or treatment) |
|
| |
Follow-up | If there is clinical concern about infection, re-check PCT after 24 h | Reassess clinical condition and re-check PCT after 48 h |
PCT result | < 1.0 μg/L | ≥ 1.0 μg/L |
Recommendation on antibiotic use | No antibiotics (or stop antibiotics) | Continue antibiotics (or start if not already on antibiotics) (consider change in antibiotics if clinically indicated) |
Over-ruling the algorithm | Empiric antibiotic therapy is permitted in patients not allocated by PCT algorithm to receive antibiotic but decision to be made only by ITU consultant or HPB consultant surgeon and documented in case notes | |
