Recent findings: Although a large number of promising diagnostic and prognostic biomarkers have been put forward in observational studies, only few have been evaluated in prospective randomized-controlled intervention trials. Markers such as lactate for risk stratification and guidance of fluid resuscitation, procalcitonin for assessing risk of bacterial infections and guiding therapeutic decisions about initiation and duration of antimicrobial therapy, and recently proadrenomedullin for early mortality prediction and site-of-care decisions in respiratory infections, have shown to improve patient management.

Summary: For few biomarkers, recent study results demonstrate that well defined clinical protocols have the potential to guide decisions about the individual risk stratification and treatment of patients with suspicion of sepsis ultimately leading to improved patient care and outcomes. For other biomarkers, promising observation data have been put forward, but their potential needs to be evaluated in large-scale, well designed prospective intervention studies before clinical use can be recommended.

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