Infectious Diseases II

MeMed BV

A host response diagnostic that differentiates bacterial from viral infection at the point of need by

computationally integrating the levels of three host immune response proteins (tumor necrosis factor-

related, apoptosis-inducing ligand [TRAIL], interferon gamma inducible protein-10 [IP-10], and

C-reactive protein [CRP]) into a score indicating the likelihood of a bacterial immune response or co-

infection versus a viral infection.

Score: 0–34 = viral infection, 35–65 = equivocal, 66–100 = bacterial infection

Delivers results in 15 minutes

Patient with signs and symptoms of infection

Initiate appropriate empiric antimicrobial therapy and obtain initial PCT

Day 3 of empiric ABX

Confirmed diagnosis of

infection through clinical and

microbiological criteria

Continue appropriate ABX,

de-escalate as appropriate, and

consider obtaining serial PCT

to determine therapy duration

PCT < 0.25 mcg/L

Strongly encourage

stopping ABX

Decrease by ≥ 80%

from peak PCT, or

PCT ≥ 0.25 and

< 0.5 mcg/L

Encourage stopping

ABX

Decrease by < 80%

from peak PCT, and

PCT ≥ 0.5 mcg/L

Encourage continuing

ABX

Increase in PCT

compared with peak

concentration and

PCT ≥ 0.5 mcg/L

Strongly encourage

continuing or

escalating ABX

Equivocal clinical suspicion

of infection

Obtain PCT and use results to

guide therapy. If PCT suggests

continuing empiric ABX, consider

obtaining serial PCT daily to

determine therapy duration

Overall, clinical suspicion for

infections is low, given clinical

resolution and negative cultures

Stop empiric ABX

ABX = antibiotics; PCT = procalcitonin.