Role of biomarkers in pediatric sepsis: What evidence says?

Sepsis is common in hospitalized pediatric patients, leading to increased morbidity, including multiple organ dysfunction and mortality. Fluid resuscitation and antibiotic administration are the primary protective mechanisms for sepsis. However, not all infections are bacterial, and unnecessary antibiotic use increases the risk of developing multidrug resistance; therefore, it is essential to distinguish bacterial from viral or other infections. Routine laboratory investigations cannot always identify the cause of diseases, but assessing different biomarker levels can help identify these infections and treat sepsis accordingly. This mini-review aims to critically analyze the available evidence supporting the use of biomarkers in pediatric sepsis. We have used the search engines PubMed, Cochrane Library, and Google Scholar to retrieve relevant information. We reviewed studies evaluating various biomarkers used for sepsis diagnoses, like C-reactive protein, ferritin, lactate, procalcitonin, tumor necrosis factor-alpha, etc. Apart from the diagnosis, trials are being conducted to assess the role of these biomarkers in monitoring and guiding antibiotic therapy to promote early recovery. The sensitivity of each biological marker varied in different studies, and no single biomarker can identify all types of infections. More robust studies are necessary to compare the roles of various biomarkers in diagnosing and guiding the appropriate therapy.