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Test Code PCT Procalcitonin

Additional Codes

ALAB: PCT

Powerchart: Procalcitonin

MA Cerner: Procalcitonin

Specimen Requirement

200 mcL Lithium heparin plasma is required; gel separator tubes are acceptable.

Additional Specimen Collection Information

  • Lithium heparin plasma is the only acceptable sample type to be used. Patients should be monitored using the same sample type.
  • Hemolysis, lipemia and icterus samples have not been found to significantly influence this assay.  However, it is not recommended to use such samples.
  • Specimens may be stored at 2-8°C for 48 hours.  If longer storage is required, freeze samples at -25±6°C. Frozen samples are stable for six months.  Three freeze/thaw cycles were validated. If samples have been frozen they must be centrifuged prior to analysis.

Test Method

MercyOne: Paramagnetic, chemiluminescent, sequential two-step immunoenzymatic “sandwich” assay; Beckman DxC700AU

 

Performance

Testing is performed Monday through Sunday.
Routine: Typically completed within 4 hours after the specimen arrives at the testing site.
STAT: Typically completed within 1 hour after the specimen arrives at the testing site.

Reference Values

Results > 0.15 ng/mL will flag as abnormal

Adults & Children ≥ 72 hours of age: ≤ 0.15 ng/mL

Children < 72 hours of age: < 2.0 ng/mL at birth, rises to ≤ 20 ng/mL at 18-30 hours of age, then falls to ≤ 0.15 ng/mL by 72 hours of age

  • < 0.5 ng/mL: low risk of sepsis
  • 0.5-2.0 ng/mL: possible risk of sepsis, retest within 6-24 hours recommended
  • > 2.0 ng/mL: high risk of sepsis and/or septic shock

Sepsis Initial Antibiotic Use Algorithm using Procalcitonin (PCT) value
Strongly consider antibiotic initiation in all patients with suspicion of infection.

  • <0.25 ng/mL Antibiotic use strongly discouraged*
  • 0.25-0.49 ng/mL.  Antibiotic use discouraged.
  • >0.5-1.0 ng/mL.  Antibiotic use encouraged.
  • >1.0 ng/mL.  Antibiotic use strongly encouraged.

* Consider alternative diagnosis. Repeat PCT in 6-12 hours if antibiotics not begun. If clinically unstable, immunosuppressed or high risk consider overruling.
If patient is treated, consider repeating daily for 3 days  to consider early antibiotic cessation (see next algorithm).


Sepsis Diagnosis FOLLOW-UP Antibiotic Use Algorithm using Procalcitonin values

  • <0.25 ng/mL.  Cessation strongly encouraged.
  • 0.25-0.49 ng/mL or drop of 80 %. Cessation encouraged.
  • 0.5 ng/mL and decreased by <80%. Cessation discouraged.
  • 0.5 ng/mL, rising, or not decreasing. Cessation strongly discouraged.

A PCT value which is rising or not declining at least 10% per day is a poor prognostic indicator and suggestions infection is not controlled.  Consider expanding antibiotic coverage or further diagnostic evaluation.
 

Lower respiratory tract infection (LRTI) Antibiotic Use Algorithm using Procalcitonin value.

  • <0.1 ng/mL.  Antibiotic use strongly discouraged.*
  • 0.1-0.24 ng/mL.  Antibiotic use discouraged.
  • >0.25-0.5 ng/mL.  Antibiotic use encouraged.
  • >0.5 ng/mL.  Antibiotic use strongly encouraged.

* Consider alternative diagnosis.  Repeat PCT in 6-12 hours if antibiotics have not begun and there is no clinical improvement.  IF clinically unstable, immunosuppressed, or high risk consider overruling.
If patient is treated, repeat every 2-3 days to consider early antibiotic cessation (see next algorithm).
 

Lower Respiratory tract infection diagnosis FOLLOW-UP Antibiotic Use Algorithm using Procalcitonin values.

  • <0.1 ng/mL or drop of >90% .  Cessation strongly encouraged unless clinically unstable.
  • 0.1-0.24 ng/mL. or drop of 80 % - Cessation encouraged unless clinically unstable.
  • >0.25-0.5 ng/mL.  Cessation discouraged.
  • >0.5 ng/mL.  Cessation strongly discouraged.

If PCT rising or not adequately decreasing, consider possible treatment failure and evaluate for need for expanding antibiotic coverage or further diagnostic evaluation.

CPT Code Information

84145  Procalcitonin

Useful For

Used in conjunction with other laboratory findings and clinical assessments, VIDAS BRAHMS PCT is intended for use to:

  • aid in decision-making on antibiotic therapy for patients with suspected or confirmed lower respiratory tract infections (LFTI) - defined as community-acquired pneumonia (CAP), acute bronchitis, and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) - in an in patient setting or an emergency department,
  • aid in decision-making on antibiotic discontinuation for patients with suspected or confirmed sepsis.

LOINC Code Information

75241-0  Procalcitonin (Mass/Volume) in Serum or Plasma by Immunoassay