Sepsis 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.
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