2019Clinical Pulmonary MedicineOpen access

Biomarkers in Pulmonary Infections

Pedro Póvoa, Luís Coelho, Lieuwe D. J. Bos

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Abstract

Pneumonia, either community acquired or hospital acquired, is the most frequent severe infection. Despite all new tools and developments, pneumonia is difficult to diagnose clinically, resulting from the lack of a “gold standard” method of diagnosis. This uncertainty is at least in part responsible for the overuse and misuse of antibiotics in the community and in the hospital, and this practice is probably a main drive for antibiotic resistance. Biomarkers may improve the clinical evaluation of a patient with a clinical suspicion of pneumonia. Among all the potential biomarkers, C-reactive protein and procalcitonin are the most extensively studied and used in clinical practice, and their role in triage, diagnosis, risk stratification, monitoring clinical course, and antibiotic stewardship has been extensively assessed. Both biomarkers showed that their use as an additional tool could be useful in the management of pneumonia. More recently “omics” technologies began to be used as new approaches in pneumonia. These promising technologies could in the near future improve the management of pneumonia.

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What this paper is about

Pneumonia, either community acquired or hospital acquired, is the most frequent severe infection. Despite all new tools and developments, pneumonia is difficult to diagnose clinically, resulting from the lack of a “gold standard” method of diagnosis. This uncertainty is at least in part responsible for the overuse and misuse of antibiotics in the community and in the hospital, and this practice is probably a main drive for antibiotic resistance. Biomarkers may improve the clinical evaluation of a patient with a clinical suspicion of pneumonia. Among all the potential biomarkers, C-reactive protein and procalcitonin are the most extensively studied and used in clinical practice, and their role in triage, diagnosis, risk stratification, monitoring clinical course, and antibiotic stewardship has been extensively assessed. Both biomarkers showed that their use as an additional tool could be useful in the management of pneumonia. More recently “omics” technologies began to be used as new approaches in pneumonia. These promising technologies could in the near future improve the management of pneumonia.

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Available abstract

Pneumonia, either community acquired or hospital acquired, is the most frequent severe infection. Despite all new tools and developments, pneumonia is difficult to diagnose clinically, resulting from the lack of a “gold standard” method of diagnosis. This uncertainty is at least in part responsible for the overuse and misuse of antibiotics in the community and in the hospital, and this practice is probably a main drive for antibiotic resistance. Biomarkers may improve the clinical evaluation of a patient with a clinical suspicion of pneumonia. Among all the potential biomarkers, C-reactive protein and procalcitonin are the most extensively studied and used in clinical practice, and their role in triage, diagnosis, risk stratification, monitoring clinical course, and antibiotic stewardship has been extensively assessed. Both biomarkers showed that their use as an additional tool could be useful in the management of pneumonia. More recently “omics” technologies began to be used as new approaches in pneumonia. These promising technologies could in the near future improve the management of pneumonia.

Key concepts: Procalcitonin, Medicine, Pneumonia, Intensive care medicine, Community-acquired pneumonia, Gold standard (test), Triage, Antibiotics

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