title: Role of biomarkers in the management of antibiotic therapy: an expert panel review: I - currently available biomarkers for clinical use in acute infections.
abstract: 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?; 2) What is their potential role in the initiation of antibiotic therapy?; and 3) What is their role in the decision to stop antibiotic therapy? To answer these questions, studies reviewed were limited to recent clinical studies (<15 years), involving a substantial number of patients (>50) and restricted to controlled trials and meta-analyses for answering questions 2 and 3. 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). Other promising biomarkers that may prove useful in the near future but need to undergo more extensive clinical testing include sTREM-1, suPAR, ProADM, and Presepsin. New approaches to biomarkers of infections include point-of-care testing and genomics.
authors.affiliation: Service de Réanimation médicale, Hôpitaux Universitaires Henri Mondor, AP-HP & Université Paris-Est, 94000 Créteil, France. Christian.brun-buisson@hmn.aphp.fr.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dupuy
authors.forename: François
authors.initials: F
authors.lastname: Philippart
authors.forename: Yves
authors.initials: Y
authors.lastname: Péan
authors.forename: Sigismond
authors.initials: S
authors.lastname: Lasocki
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Charles
authors.forename: Martin
authors.initials: M
authors.lastname: Chalumeau
authors.forename: Yann-Eric
authors.initials: YE
authors.lastname: Claessens
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Quenot
authors.forename: Christele Gras-Le
authors.initials: CG
authors.lastname: Guen
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ruiz
authors.forename: Charles-Edouard
authors.initials: CE
authors.lastname: Luyt
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Stahl
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bedos
authors.forename: Jérôme
authors.initials: J
authors.lastname: Pugin
authors.forename: Rémy
authors.initials: R
authors.lastname: Gauzit
authors.forename: Benoit
authors.initials: B
authors.lastname: Misset
authors.forename: Christian
authors.initials: C
authors.lastname: Brun-Buisson