Procalcitonin Importance in Monitoring and Prognosis of Lower Respiratory Tract Infections in Children

Introduction: Lower respiratory tract infections in children is the most frequent cause of hospitalization in developed countries and the second leading cause of death in developing countries, prompting intense study of this pathology. The serum level of Procalcitonin it is increased in bacterial infections, increase rapidly in 3 to 6 hours after the onset of infection, which helps to monitor the evolution and in the same time the severity of the infection. The level of procalcitonin concentration reflects the systemic response to bacterial infection and its severity.

Methods: The study involved 105 children who were hospitalized in Pediatric Clinic Hospital of Sibiu between January 2013 and January 2016. Children hospitalized with lower respiratory tract infections, who presented at the admission in the hospital: malaise, fever, respiratory functional signs, the biological samples have confirmed us the bacterial infection and chest x-ray amended. We determined procalcitonin at hospital admission and during antibiotherapy in order to monitor the clinical evolution.

Results: The most of the hospitalized children were male 56, 19%, from urban areas 59, 04%. All patients at admission in the hospital have had the value of procalcitonin increased, the value higher than 0.5 ng / mL, but after 3 to 5 days of antibiotics the value of procalcitonin has decreased. 60.95% of patients received only one type of antibiotic, and 39, 04% have had associated two antibiotics. Most cases had favorable prognosis (74.28%) with negative procalcitonin after the treatment, and 25, 71% were complicated with pleurisy. 17, 14% of cases required hospitalization longer than 20 days, with maintaining increase the level of procalcitonin (>10 ng/mL).

Conclusion: The level of serum procalcitonin correlates with bacterial infections, severity of infections and in the same time is useful to predict the prognosis of our patients, both in complicated cases and those that have a favorable evolution after the treatment.

Keywords: procalcitonin, children, bacterial infection, lower respiratory tract infection, severity