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LETTER TO EDITOR
Year : 2019  |  Volume : 22  |  Issue : 10  |  Page : 1462

Comment on: “Value of procalcitonin levels as a predictive biomarker for sepsis in pediatric patients with burn injuries”


1 Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication14-Oct-2019

Correspondence Address:
Dr. A Saffaei
Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njcp.njcp_414_19

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How to cite this article:
Sahraei Z, Abtahi-Naeini B, Saffaei A. Comment on: “Value of procalcitonin levels as a predictive biomarker for sepsis in pediatric patients with burn injuries”. Niger J Clin Pract 2019;22:1462

How to cite this URL:
Sahraei Z, Abtahi-Naeini B, Saffaei A. Comment on: “Value of procalcitonin levels as a predictive biomarker for sepsis in pediatric patients with burn injuries”. Niger J Clin Pract [serial online] 2019 [cited 2019 Nov 17];22:1462. Available from: http://www.njcponline.com/text.asp?2019/22/10/1462/269018



Sir,

We have this chance to read the valuable article of Kundes et al., entitled “Value of Procalcitonin Levels as a Predictive Biomarker for Sepsis in Pediatric Patients with Burn Injuries” which published in the last issue of journal.[1] The authors emphasized the prognostic value of procalcitonin for the development of sepsis in pediatric patients with a burning complaint. The authors categorized the procalcitonin level into three groups as: lower than 0.5 ng/dL, between 0.5 and 2.0 ng/dL, and more than 2 ng/dL. Then, all necessary comparisons were done between these three groups. First, the unit of these values is written wrongly and ng/mL should be used for the above values. Also, these cut-off values of procalcitonin are acceptable cut-off among adult patients.[2],[3] However, these cut-off are not proven in the pediatric population. Recent studies have defined new cut-off corresponding to the age. Because neonates and pediatrics have a complex mature status of immune system, endocrine system, or metabolism system, the procalcitonin level of pediatrics should be measured by distinguished references according to their age.[4] Also, the term or preterm status of patients can significantly affect the procalcitonin level. For example, the 50-percentile value of procalcitonin in late preterm and term infants reached to 0.1 ng/mL following five days old; however, it did not reach in preterm infants.[5] However, this recommendation may be difficult in point of data analysis. Hence, it is suggested to analyze the data without procalcitonin categorization. It means that to consider the procalcitonin as a scale variable instead of a nominal variable. By this way, a true relation between variables can be detected and its clinical applicability can be interoperated with more accuracy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Kundes M, Kement M. Value of procalcitonin levels as a predictive biomarker for sepsis in pediatric patients with burn injuries. Niger J Clin Pract 2019;22:881-4.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Rhee C. Using procalcitonin to guide antibiotic therapy. Open Forum Infect Dis 2016;4:1-10.  Back to cited text no. 2
    
3.
Schuetz P, Albrich W, Mueller B. Procalcitonin for diagnosis of infection and guide to antibiotic decisions: Past, present and future. BMC Med 2011;9:107.  Back to cited text no. 3
    
4.
Fukuzumi N, Osawa K, Sato I, Iwatani S, Ishino R, Hayashi N, et al. Age-specific percentile-based reference curve of serum procalcitonin concentrations in Japanese preterm infants. Sci Rep 2016;6:23871.  Back to cited text no. 4
    
5.
Turner D, Hammerman C, Rudensky B, Schlesinger Y, Goia C, Schimmel MS. Procalcitonin in preterm infants during the first few days of life: Introducing an age related nomogram. Arch Dis Child Fetal Neonatal Ed 2006;91:F283-6.  Back to cited text no. 5
    




 

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