ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Procalcitonin as a Marker of Etiology in Adults Hospitalized With Community-Acquired Pneumonia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 2 of them syntheses that pooled it.
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Who cites it
123 citing papers in PubMed, 2 syntheses or guidelines pooled it, 246 citations in OpenAlex.
- Diagnostic value of procalcitonin for identifying the etiology of lower respiratory tract infections: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.American journal of respiratory and critical care medicine · 2019Guideline
- C-reactive protein or procalcitonin combined with rhinorrhea for discrimination of viral from bacterial infections in hospitalized adults in non-intensive care units with lower respiratory tract infections.BMC pulmonary medicine · 2021Trial
- Thrombomodulin is associated with increased mortality and organ failure in mechanically ventilated children with acute respiratory failure: biomarker analysis from a multicenter randomized controlled trial.Critical care (London, England) · 2021Trial
- Enhanced Detection of Community-Acquired Pneumonia Pathogens With the BioFire® Pneumonia FilmArray® Panel.Diagnostic microbiology and infectious disease · 2021Trial
- Influence of pathogen and focus of infection on procalcitonin values in sepsis patients with bacteremia or candidemia.Critical care (London, England) · 2018Trial
- Acute exacerbation in fibrotic interstitial lung disease: an international working group report.American journal of respiratory and critical care medicine · 2026Review
- Impact of Procalcitonin Testing on Antibiotic Use in Patients Hospitalized With Community-Acquired Pneumonia: A Multi-Hospital Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Procalcitonin-Guided Antimicrobial Therapy: Current Evidence for Clinical Decision-Making and Practical Limitations.Cureus · 2026Review
- Paradoxical Acute Hypoxemic Deterioration During Treatment of Bilateral Bronchopneumonia: A Case Report.Cureus · 2026Article
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Pathogen-specific host responses define distinct pneumonia endotypes in the human lung.bioRxiv : the preprint server for biology · 2026Article
- Host-microbiome archetypes differentiate infection from pathogen carriage in the human lower airway.Nature communications · 2026Article
- Clinical assessment and biomarkers for the detection of bacterial community-acquired pneumonia in children and adults: a protocol for systematic review of diagnostic accuracy.Systematic reviews · 2026Article
- Procalcitonin in the management of lower respiratory tract infection and sepsis.The Journal of antimicrobial chemotherapy · 2026Article
- Lactate dehydrogenase-to-albumin ratio predicts 30-day and 90-day mortality in glucocorticoid-treated ICU patients with pneumonia: a secondary analysis of a multicenter cohort.Frontiers in medicine · 2026Article
- Artificial Intelligence Applications in Pneumonia: Diagnosis and Outcome Prediction.Current pulmonology reports · 2026Review
- Diagnostic efficacy of monocyte distribution width to high-sensitivity C-reactive protein ratio in differentiating pathogen types in community-acquired pneumonia: a retrospective cohort study.Open medicine (Warsaw, Poland) · 2026Article
- Lactate dehydrogenase-to-albumin ratio as a potential prognostic indicator in glucocorticoid-treated severe pneumonia: a multicenter retrospective study with external validation.Frontiers in immunology · 2026Article
- Article
63 more citing papers are in PubMed but not listed here.
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundRecent trials suggest procalcitonin-based guidelines can reduce antibiotic use for respiratory infections. However, the accuracy of procalcitonin to discriminate between viral and bacterial pneumonia requires further dissection.
methodsWe evaluated the association between serum procalcitonin concentration at hospital admission with pathogens detected in a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia. Systematic pathogen testing included cultures, serology, urine antigen tests, and molecular detection. Accuracy of procalcitonin to discriminate between viral and bacterial pathogens was calculated.
resultsAmong 1735 patients, pathogens were identified in 645 (37%), including 169 (10%) with typical bacteria, 67 (4%) with atypical bacteria, and 409 (24%) with viruses only. Median procalcitonin concentration was lower with viral pathogens (0.09 ng/mL; interquartile range [IQR], <0.05-0.54 ng/mL) than atypical bacteria (0.20 ng/mL; IQR, <0.05-0.87 ng/mL; P = .05), and typical bacteria (2.5 ng/mL; IQR, 0.29-12.2 ng/mL; P < .01). Procalcitonin discriminated bacterial pathogens, including typical and atypical bacteria, from viral pathogens with an area under the receiver operating characteristic (ROC) curve of 0.73 (95% confidence interval [CI], .69-.77). A procalcitonin threshold of 0.1 ng/mL resulted in 80.9% (95% CI, 75.3%-85.7%) sensitivity and 51.6% (95% CI, 46.6%-56.5%) specificity for identification of any bacterial pathogen. Procalcitonin discriminated between typical bacteria and the combined group of viruses and atypical bacteria with an area under the ROC curve of 0.79 (95% CI, .75-.82).
conclusionsNo procalcitonin threshold perfectly discriminated between viral and bacterial pathogens, but higher procalcitonin strongly correlated with increased probability of bacterial pathogens, particularly typical bacteria.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.