“swine flu” or pneumonia?

Ingram PR, Inglis T, Moxon D, Speers D. Procalcitonin and C-reactive protein in severe 2009 H1N1 influenza infection. Intensive Care Med. 2010 Jan 13. [Epub ahead of print]

When we were faced with an influx of ICU patients with H1N1/09 influenza, we wanted a more rapid method of distinguishing bacterial pneumonia from influenza to help with antibiotic decisions. We had expected the procalcitonin would be the most effective decision support but it turned out that C-reactive protein was a bit better as a single test, and the most effective was a combination of both when ruling out serious bacterial infection.

Pro-calcitonin has become a useful test in ICU, supporting decisions regarding the progression of bacterial infection and the need for antibiotic interventions (1,2). It will be interesting to see how the combination of CRP and PCT fares during the next influenza surge.

  1. Tsangaris I, Plachouras D, Kavatha D, Gourgoulis GM, Tsantes A, Kopterides P, Tsaknis G, Dimopoulou I, Orfanos S, Giamarellos-Bourboulis E, Giamarellou H, Armaganidis A. Diagnostic and prognostic value of procalcitonin among febrile critically ill patients with prolonged ICU stay. Crit Care. 2009;13(2):R38.
  2. Charles PE, Tinel C, Barbar S, Aho S, Prin S, Doise JM, Olsson NO, Blettery B, Quenot JP.Procalcitonin kinetics within the first days of sepsis: relationship with the appropriateness of antibiotic therapy and the outcome. BMC Infect Dis. 2009 Dec 22;9:213.



  1. 2 of my cousins in mexico got infected with the swine flu virus. thank God, they recovered well. it is a great news that the pandemic on swine flu is gone now.

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