Biomarkers in intensive care unit infections, friend or foe?

Antibiotic misuse is a crucial problem for critically ill patients. Biomarkers have emerged as tools to assist the clinician in antimicrobial therapy decisions among critically ill patients in intensive care units (ICU). They are useful for early identification of infection, timely initiation of antimicrobial therapy, and prompt evaluation of treatment course or duration. However, until now, an ideal biomarker has not yet been identified. The combination of procalcitonin (PCT), C-reactive protein (CPR) and other biomarkers may overcome their insufficiencies, with the high sensitivity of CRP compensating for the low sensitivity of PCT. Biomarkers could not predict antimicrobial resistance, and development of molecular diagnosis brings new challenges. The most important thing for the clinician is to understand the advantages and disadvantages of different methods so that to use them reasonably.