Chien Chang LeeAndrea Lay Hoon KwaAnucha ApisarnthanarakJia Yih FengEric Howard GluckAkihiro ItoAnis KaruniawatiPetrick PeriyasamyBusadee PratumvinitJeetendra SharmaRontgene SolanteSubramanian SwaminathanNiraj TyagiDien Minh VuKapil ZirpePhilipp SchuetzDuke-NUS Medical School SingaporeArtemis Health SciencesNational Taiwan University HospitalSan Lazaro HospitalUniversity of Indonesia, RSUPN Dr. Cipto MangunkusumoThammasat University HospitalSir Ganga Ram HospitalUniversitat BaselKantonsspital AarauSingapore General HospitalSwedish Covenant HospitalVeterans General Hospital-TaipeiFaculty of Medicine, Siriraj Hospital, Mahidol UniversityKurashiki Central HospitalUniversiti Kebangsaan MalaysiaB.G.S Gleneagles Global HospitalNational Hospital of Tropical DiseasesGrant Medical Foundation2020-03-262020-03-262020-01-01Clinical Chemistry and Laboratory Medicine. (2020)14374331143466212-s2.0-85078219846https://repository.li.mahidol.ac.th/handle/20.500.14594/53615© 2020 ©2020 Philipp Schuetz et al., published by De Gruyter, Berlin/Boston. Recently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care. Practical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific. Using a Delphi process, the group reached consensus on two PCT algorithms for the critically ill and the non-critically ill patient populations. The group agreed that the existing evidence for PCT-guided antibiotic stewardship in patients with acute respiratory infections and sepsis is generally valid also for Asia-Pacific countries, in regard to proposed PCT cut-offs, emphasis on diagnosis, prognosis and antibiotic stewardship, overruling criteria and inevitable adaptations to clinical settings. However, the group noted an insufficient database on patients with tropical diseases currently limiting the clinical utility in these patients. Also, due to lower resource availabilities, biomarker levels may be measured less frequently and only when changes in treatment are highly likely. Use of PCT to guide antibiotic stewardship in conjunction with continuous education and regular feedback to all stakeholders has high potential to improve the utilization of antibiotic treatment also in Asia-Pacific countries. However, there is need for adaptations of existing algorithms due to differences in types of infections and routine clinical care. Further research is needed to understand the optimal use of PCT in patients with tropical diseases.Mahidol UniversityBiochemistry, Genetics and Molecular BiologyMedicineArticleSCOPUS10.1515/cclm-2019-1122