Annals of Intensive Care volume 3 , Article number: 22 Cite this article. Metrics details. In the context of worldwide increasing antimicrobial resistance, good antimicrobial prescribing in more needed than ever; unfortunately, information available to clinicians often are insufficient to rely on.
Biomarkers might provide help for decision-making and improve antibiotic management. The purpose of this expert panel review was to examine currently available literature on the potential role of biomarkers to improve antimicrobial prescribing, by answering three questions: 1 Which are the biomarkers available for this purpose?
With regard to the first question concerning routinely available biomarkers, which might be useful for antibiotic management of acute infections, these are currently limited to C-reactive protein CRP and procalcitonin PCT. New approaches to biomarkers of infections include point-of-care testing and genomics. Good antibiotic prescribing-which often means less prescribing-is of major concern to physicians nowadays, both because of high levels of antibiotic consumption in hospitals, and of the increasing prevalence of antimicrobial resistance, even if rates of methicillin-resistant Staphylococcus aureus have decreased recently in many European countries since the early s.
The principal objective of antibiotic prescribing is to ensure appropriate therapy when needed, while avoiding unnecessary or unduly prolonged therapy. Whereas clinical information is usually sufficient to initiate empiric therapy, they lack accuracy to tailor subsequent therapy and decide on its duration. The field of infection-associated biomarkers has grown rapidly within the past few years and is still expanding; few of them, however, have gone through the hurdles of rigorous testing in the clinical arena to allow specifying their role in clinical practice.
This report is a summary of their work and conclusions. To frame the appraisal of the potential clinical role of biomarkers, the panel was asked to answer three formatted questions, as follows:. What is the potential contribution of such biomarkers to the initial decision of antibiotic prescription, and does this vary according to the characteristics of infection i. When can biomarkers help make decisions to stop antibiotic therapy, and which factors mitigate their clinical use in this process?
