A Practical Guide to the Roles of Procalcitonin Measurement in Patients with Acute Pancreatitis

Background/Objectives: This review is a concise summary of the current roles and indications for procalcitonin measurement in the management of patients with acute pancreatitis. Methods: The National Library of Medicine’s PubMed database for the period 1 January 2000 to 27 November 2025 was interrogated using the keywords “procalcitonin” and “acute pancreatitis”. Articles on gut dysbiosis in acute pancreatitis, procalcitonin and its role as a predictor of disease severity, a marker of pancreatic necrosis and a guide to antibiotic therapy in acute pancreatitis were retrieved. Results: Persistently elevated procalcitonin levels are indicators of disease severity and necrosis in acute pancreatitis. In the setting of acute pancreatitis with raised inflammatory markers, a procalcitonin level >1 ng/mL has evidentiary proof for use as an indicator for starting antibiotic therapy. Conclusions: In current practice, in patients with acute pancreatitis and raised inflammatory markers but without positive microbiological cultures, a procalcitonin level >1 ng/mL can be used as an indicator for starting antibiotic therapy.