Because of the diverse etiologies of community-acquired pneumonia (CAP) and the limitations of current diagnostic modalities, serum procalcitonin levels have been proposed as a novel tool to guide antibiotic therapy. Outcome data from procalcitonin-guided therapy trials have shown similar mortality, but the essential question is whether the sensitivity and specificity of procalcitonin levels enable the practitioner to distinguish bacterial pneumonia, which requires antibiotic therapy, from viral pneumonia, which does not. In this meta-analysis of 12 studies in 2408 patients with CAP that included etiologic diagnoses and sufficient data to enable analysis, the sensitivity and specificity of serum procalcitonin were 0.55 (95% confidence interval [CI], .37–.71; I² = 95.5%) and 0.76 (95% CI, .62–.86; I² = 94.1%), respectively. Thus, a procalcitonin level is unlikely to provide reliable evidence either to mandate administration of antibiotics or to enable withholding such treatment in patients with CAP.

中文翻译：

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降钙素原可区分细菌性肺炎的病毒：系统评价和荟萃分析

由于社区获得性肺炎（CAP）的病因多种多样，并且当前诊断方式存在局限性，因此血清降钙素原水平已被提议作为指导抗生素治疗的新工具。降钙素指导的治疗试验的结果数据显示出相似的死亡率，但基本问题是降钙素水平的敏感性和特异性是否可使从业者区分需要抗生素治疗的细菌性肺炎和不需要病毒治疗的病毒性肺炎。在这项针对2408例CAP患者的12项研究的荟萃分析中，包括病因诊断和足够的数据以进行分析，血清降钙素原的敏感性和特异性为0.55（95％置信区间[CI] ，. 37–.71； I ² = 95.5％）和0.76（95％CI，.62–.86; I² = 94.1％）。因此，降钙素原水平不太可能提供可靠的证据来强制性给予抗生素治疗或使CAP患者停药。