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    B R A H M S PCT: Procalcitonin (PCT) Reference Values in Neonatology

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    Ngai29
    This document provides guidance on using procalcitonin (PCT) reference values to help determine the duration of antibiotic therapy for neonatal early onset sepsis and rule out nosocomial infection in neonatal ICUs. It describes a risk stratification system using maternal and newborn risk factors and symptoms to determine the probability of infection and how often to measure PCT levels. It also shows normal hourly PCT levels after birth to rule out maternal-fetal bacterial infection and references studies supporting the use of PCT.

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    B R A H M S PCT: Procalcitonin (PCT) Reference Values in Neonatology

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    Ngai29
    52 views2 pages
    This document provides guidance on using procalcitonin (PCT) reference values to help determine the duration of antibiotic therapy for neonatal early onset sepsis and rule out nosocomial infection in neonatal ICUs. It describes a risk stratification system using maternal and newborn risk factors and symptoms to determine the probability of infection and how often to measure PCT levels. It also shows normal hourly PCT levels after birth to rule out maternal-fetal bacterial infection and references studies supporting the use of PCT.

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    This document provides guidance on using procalcitonin (PCT) reference values to help determine the duration of antibiotic therapy for neonatal early onset sepsis and rule out nosocomial infection in neonatal ICUs. It describes a risk stratification system using maternal and newborn risk factors and symptoms to determine the probability of infection and how often to measure PCT levels. It also shows normal hourly PCT levels after birth to rule out maternal-fetal bacterial infection and references studies supporting the use of PCT.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    52 views2 pages

    B R A H M S PCT: Procalcitonin (PCT) Reference Values in Neonatology

    Uploaded by

    Ngai29
    This document provides guidance on using procalcitonin (PCT) reference values to help determine the duration of antibiotic therapy for neonatal early onset sepsis and rule out nosocomial infection in neonatal ICUs. It describes a risk stratification system using maternal and newborn risk factors and symptoms to determine the probability of infection and how often to measure PCT levels. It also shows normal hourly PCT levels after birth to rule out maternal-fetal bacterial infection and references studies supporting the use of PCT.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    B·R·A·H·M·S PCT

    Procalcitonin (PCT) Reference Values


    in Neonatology

    Neonatal Early Onset Sepsis (EOS)1


    PCT guidance to discontinue antibiotic therapy
    Risk stratification = Risk assessment score + Neonatal blood culture result

    Risk assessment
    Advised within 12 hrs of initiation of antibiotic therapy
    Max score = 3
    Risk factors Check box if positive
    1 Mother Group B streptococcus positive
    2 Maternal chorioamnionitis (fever >38.5,
    fetal tachycardia
    3 Premature rupture membranes >18 hours
    4 Gestational age <37 weeks A=
    0 boxes checked? Score = 0 | ≥1 box checked? Score = 1  0/1

    Clinical symptoms Check box if positive


    1 Respiratory distress or apnoea
    2 Tachycardia or bradycardia
    3 Arterial hypotension and/or poor perfusion
    4 Hypothermia or hyperthermia
    5 Seizure, floppy infant, irritability, or lethargy
    6 Vomiting or feeding intolerance or ileus B=
    0 boxes checked? Score = 0 | ≥1 box checked? Score = 1  0/1

    Laboratory findings Check box if abnormal


    1 White blood cells <5x10 E9 cells per L
    2 C-reactive protein >10 mg/L C=
    0 boxes checked? Score = 0 | ≥1 box checked? Score = 1  0/1

    Calculate total risk score A+B+C   0-3


    Blood Total risk Risk stratification Duration of antibiotic
    ­culture score category therapy
    Neg 0/1 4: Infection PCT guidance
    unlikely (low risk) • First PCT measurement* as
    Neg 2 3: Infection early as possible
    possible • Repeat PCT measurement
    (medium risk) (every 24 hrs is recommended)
    Continue antibiotic therapy
    at least 24 hrs.
    STOP after 2 consecutive PCT
    values are within range.
    Neg 3 2: Infection
    probable
    (high risk) Continue, as per guidelines
    Pos ≥1 1: Infection proven

    20 Normal hourly values of


    post-birth PCT to rule out
    10 maternal-fetal bacterial infection 2
    5
    PCT [μg/L]

    2
    1
    0.5
    0.1
    0
    0 6 12 18 24 30 36 42 48 54 60 66 72 78 84 90
    Time after birth (hours)
    * PCT can be measured in the venous blood including venous blood from the umbilical
    cord, for detecting early onset neonatal sepsis.3

    Neonatal Late Onset Sepsis 4


    Rules out nosocomial infection in
    PCT <0.5 μg/L neonatal ICUs with negative ­predictive
    value 94.6%

    References 1 Stocker et al., Lancet 2017; 390: 871–81. 2 Stocker et al., Neonatology 2010;
    97: 165-74. 3 Chiesa et al., Clin Chem 2003; 49(1): 60-8. 4 Isidor et al., Scand J Infect Dis
    2007; 39: 1063-6.

    Thermo Fisher Scientific · B·R·A·H·M·S GmbH · Neuendorfstr. 25


    16761 Hennigsdorf/Germany · info.pct@thermofisher.com

    Find out more at thermoscientific.com/procalcitonin

    © 2018 Thermo Fisher Scientific Inc. All rights reserved. B·R·A·H·M·S PCT and all other
    trademarks are the property of Thermo Fisher Scientific and its subsidiaries unless
    otherwise specified. Thermo Fisher Scientific products
    are distributed world­­wide; not all intended uses and
    applications mentioned in this printing are registered in
    every country. This indication for use is not cleared in
    the USA.
    107626.1

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