Table 2 PCT assays and algorithms used for procalcitonin (PCT)-guided treatment in the included studies

Annane et al. 2013[26]

Brahms PCT Kryptor

Medical patients:

Antibiotic treatment at the discretion of the patient’s physician

PCT <0.25 ng/mL: antibiotics not initiated or stopped

PCT ≥ 0.25 and < 0.5 ng/mL: Antibiotics strongly discouraged

PCT ≥0.5 and <5 ng/mL: antibiotics recommended

PCT ≥5 ng/mL: antibiotics strongly recommended

Surgical patients:

PCT <4 ng/mL: antibiotics not initiated or stopped

PCT ≥4 and <9 ng/mL: antibiotics recommended

PCT ≥9 ng/mL: antibiotics strongly recommended

Bouadma et al. 2010[27]

Brahms PCT Kryptor

Guidelines for starting of antibiotics:

Treatment according to international and local guidelines

PCT <0.25 ng/mL: antibiotics strongly discouraged

PCT ≥0.25 and <0.5 ng/mL: antibiotics discouraged

PCT ≥0.5 and <1 ng/mL: antibiotics encouraged

PCT ≥1 ng/mL: antibiotics strongly encouraged

Guidelines for continuing or stopping of antibiotics:

PCT <0.25 ng/mL: stopping of antibiotics strongly encouraged.

Decrease by ≥80% from peak concentration, or concentration ≥0.25 and <0.5 ng/mL: stopping of antibiotics encouraged

Decrease by <80% from peak concentration and concentration ≥0.5 ng/mL: continuing of antibiotics encouraged

Increase of concentration compared with peak concentration and concentration ≥0.5 ng/mL: changing of antibiotics strongly encouraged

Hochreiter et al. 2009[28]

Brahms PCT LIA

PCT < 1 ng/mL: Antibiotics discontinued.

Antibiotic treatment according to standard regimen over 8 days

PCT >1 ng/mL and dropped to 25 to 35% of the initial value over 3 days: antibiotics discontinued

Additionally the infection had to improve clinically

Jensen et al. 2011[29]

Brahms PCT Kryptor

Single baseline measurement of PCT ≥1.00 ng/mL or PCT ≥1.00 ng/mL and not decreased at least 10% from the previous day:

Antibiotic treatment according to current guidelines

1) increasing the antimicrobial spectrum covered

2) intensifying the diagnostic effort to find uncontrolled sources of infection

PCT <1.00 ng/mL for at least 3 days: de-escalation possible

Nobre et al. 2008[30]

Brahms PCT Kryptor

Patients with PCT <1 ng/mL re-evaluated at day 3: antibiotics discontinued if PCT <0.1 ng/mL

Antibiotic treatment based on empirical rules

Patients with PCT ≥1 ng/mL re-evaluated at day 5: antibiotics discontinued if PCT dropped >90% from the baseline peak level or if PCT <0,25 ng/mL

Schroeder et al. 2009[31]

Brahms PCT LIA

PCT <1 ng/mL and clinical signs of infection improved: antibiotics discontinued

Antibiotic treatment according to clinical signs and empiric rules

PCT dropped to <35% of the initial concentration within 3 days and clinical signs of infection improved: antibiotics discontinued

Svoboda et al. 2007[32]

Brahms PCT-Q

PCT >2 ng/mL: change of antibiotics and catheters

Treatment according to contemporary treatment protocol of the institute

PCT ≤2 ng/mL: ultrasonography and/or computer tomography followed by repeated surgical treatment if localized infection was confirmed