Comparing Procalcitonin v/s C-Reactive Protein and Total White Blood Cell Count as an Early Predictive Marker of Severity in Acute Pancreatitis and Guide to Initiate Antibiotic Therapy

Dr. Yogeshwari, Dr. Khalid Muqueem

Abstract: Background: Early prediction of severity in acute pancreatitis is important as 20% of patient develops acute severe pancreatitis (ASP) which include multiple organ failure, local complications, pancreatic necrosis with 15-20% mortality. Sometimes clinical and regular markers of sepsis, such as WBC and CRP levels, mislead us to start unnecessary higher antibiotics which leads to emerging antibacterial resistance, increased cost and significant mortality. AIM: To evaluate the role of procalcitonin v/s c-reactive protein, white blood cell counts in early diagnosis of severity in acute pancreatitis and guide initiation of appropriate antibiotic therapy. Methods: This study was done in 30 patients admitted in Ballari Medical College and Research Center (BMCRC), Ballari for period of 3months, study design ? prospective, comparative study. Procalcitonin levels checked for 50% of population and CRP, WBC counts for another 50% of population with Acute pancreatitis. Procalcitonin levels of <1ng/ml considered low risk and not started antibiotics, if 1to5ng/ml started with basic antibiotics and >10ng/ml started with higher antibiotics. High CRP, WBC counts started with higher antibiotics. Results: Our study demonstrating that PCT levels at admission accurately identify patients likely to progress to severe AP with better diagnostic accuracy of 91.9% compared to CRP and WBC count of 90.1% and 73.9% respectively. And guided to start appropriate antibiotics based on severity and reduced mortality with significant p value. Conclusion: This comparative study evaluates the effectiveness of procalcitonin PCT, C reactive protein CRP, and total white blood cell WBC count as early predictive markers of severity in acute pancreatitis AP. The study enrolled 30 patients with AP, dividing them into two groups for PCT or CRP/WBC guided group. Results showed that PCT had a diagnostic accuracy of 91.9%, compared to CRP 90.1% and WBC count 73.9%. Early PCT based antibiotic initiation led to reduced mortality and shorter hospital stays. These findings suggest that PCT is a superior marker for early diagnosis and effective treatment in severe AP cases.

Keywords: Acute pancreatitis, procalcitonin, C reactive protein, white blood cell count, severity markers

How to Cite?: Dr. Khalid Muqueem, "Comparing Procalcitonin v/s C-Reactive Protein and Total White Blood Cell Count as an Early Predictive Marker of Severity in Acute Pancreatitis and Guide to Initiate Antibiotic Therapy", Volume 13 Issue 10, October 2024, International Journal of Science and Research (IJSR), Pages: 1266-1269, https://www.ijsr.net/getabstract.php?paperid=MR241017212609, DOI: https://dx.doi.org/10.21275/MR241017212609