title: Evaluation of procalcitonin as a marker to predict antibiotic response in adult patients with acute appendicitis: a prospective observational study.
abstract: BACKGROUND
  The aim of the study was to investigate the value of serum procalcitonin (PCT) as a predictor of early antibiotic treatment response in patients with acute appendicitis. Procalcitonin is a biochemical marker that increases rapidly in cases of bacterial infection and sepsis; however, the benefit of PCT as a diagnostic tool in acute appendicitis has not been confirmed.
  
  
  METHODS
  Observations of PCT dynamics were conducted as part of a prospective clinical trial at Sahlgrenska University Hospital between May 2009 and February 2010 on adult patients with acute appendicitis treated with antibiotics as first-line therapy. Procalcitonin, C-reactive protein (CRP), and white blood cell count (WBC) were measured before administration of antibiotics and subsequently between 4-24 h following treatment.
  
  
  RESULTS
  Three hundred sixteen patients were included in the study. Almost 80% recovered on antibiotics without the need of surgery. Serum PCT concentrations before initiation of antibiotic therapy and during treatment did not differ significantly between antibiotic responders and non-responders (p<0.94). However, differences were observed for CRP (p<0.04) and WBC (p<0.001), with a trend for body temperature (p<0.06).
  
  
  CONCLUSIONS
  Procalcitonin has limited additional value, compared with standard laboratory tests as CRP, WBC, and body temperature to predict antibiotic treatment response in adult patients with acute appendicitis.
authors.affiliation: Department of Surgery, Sahlgrenska University Hospital , Gothenburg, Sweden .
authors.forename: Jeanette
authors.initials: J
authors.lastname: Assarsson
authors.forename: Ulla
authors.initials: U
authors.lastname: Körner
authors.forename: Kent
authors.initials: K
authors.lastname: Lundholm
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001064:Appendicitis / Q000097:blood* / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide