• Pedro Póvoa, Luís Coelho, Felipe Dal-Pizzol, Ricard Ferrer, Angela Huttner, Conway MorrisAndrewA0000-0002-3211-3216Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK.Division of Immunology, Department of Pathology, University of Cambridge, Cambridge, UK.JVF Intensive Care Unit, Addenbrooke's H, Vandack Nobre, Paula Ramirez, Anahita Rouze, Jorge Salluh, Mervyn Singer, Daniel A Sweeney, Antoni Torres, Grant Waterer, and Andre C Kalil.
• NOVA Medical School, New University of Lisbon, Lisbon, Portugal. pedrorpovoa@gmail.com.
• Intensive Care Med. 2023 Feb 1; 49 (2): 142153142-153.

AbstractSepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In this context, biomarkers could be considered as indicators of either infection or dysregulated host response or response to treatment and/or aid clinicians to prognosticate patient risk. More than 250 biomarkers have been identified and evaluated over the last few decades, but no biomarker accurately differentiates between sepsis and sepsis-like syndrome. Published data support the use of biomarkers for pathogen identification, clinical diagnosis, and optimization of antibiotic treatment. In this narrative review, we highlight how clinicians could improve the use of pathogen-specific and of the most used host-response biomarkers, procalcitonin and C-reactive protein, to improve the clinical care of patients with sepsis. Biomarker kinetics are more useful than single values in predicting sepsis, when making the diagnosis and assessing the response to antibiotic therapy. Finally, integrated biomarker-guided algorithms may hold promise to improve both the diagnosis and prognosis of sepsis. Herein, we provide current data on the clinical utility of pathogen-specific and host-response biomarkers, offer guidance on how to optimize their use, and propose the needs for future research.© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.

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