Procalcitonin (PCT) is an early diagnostic marker for severe bacterial infection and sepsis with diagnostic and prognostic properties.
Pct-guided antibiotic management has been shown to reduce antibiotic use and improve clinical outcomes.
Expert consensus on PCT guidance for antibiotic management has been published in Europe and the United States to provide guidance for the use of PCT guidance for antibiotic treatment.
However, due to differences in infection types, patient populations, available resources and clinical standards in asia-pacific countries, the guidelines in the consensus need to be revised in order to be applicable in asia-pacific countries.
Using Delphi method, the Asia-Pacific expert group reached two consensus on the application of PCT in critical and non-critical patients.

The use of PCT to guide antibiotic management in patients with acute respiratory infections and sepsis is also applicable in the Asia-Pacific region.
The application of PCT in non-severe (mild to moderate) and severe (severe) patients is shown in Figure 1 and Figure 2.

First, patients should be stratified according to clinical criteria and probability of bacterial infection (infection is uncertain and highly suspected).
Then, the PCT level was applied to evaluate the patients, and the critical PCT value of non-critical patients was & LT;
0.25 mu g/L;
The critical PCT value of severe patients was & LT;
0.5 g/L suggests low possibility of bacterial infection.

Low PCT levels are not recommended in non-severe patients with low risk of bacterial infection.
In critically ill patients undergoing empirical antibiotic treatment, PCT should be revisited 6-24 hours later to reassess the need for antibiotic treatment.
Therefore, the purpose of PCT testing in critically ill patients is to discontinue antibiotics rather than to enable antibiotic therapy.

Continuous testing of PCT levels to monitor responses to antibiotic treatment and infection control is recommended for patients starting empirical antibiotic therapy.
When PCT level drops from peak & GT;
When 80% and/or below the critical value and the patient is clinically stable, early discontinuation of antibiotics is recommended.

Due to the lack of systematic PCT guidance and antibiotic management studies in patients with clinically suspected tropical diseases such as malaria, dengue fever, haemorrhagic fevers and other diseases with high prevalence in the asia-pacific region.
The panel noted that management of these patients should be based on clinical evidence and international recommendations, and that PCT should not be used to guide any antibiotic use decision.

For outpatient and emergency patients, initial PCT levels help assess the likelihood of bacterial infection and the need for antibiotic treatment.
Highly sensitive real-time diagnostic equipment enables rapid decision making.
 

Integrating PCT into antibiotic management can improve the diagnosis and management of patients with respiratory infections and sepsis, reduce the global bacterial resistance crisis and provide guidance for more personalized treatment decisions in asia-pacific countries where antibiotic overuse is a serious problem.