Background: Acute pancreatitis (AP) is a highly variable inflammatory disorder with clinical presentations ranging from mild, self-limiting illness to severe disease associated with systemic inflammatory response syndrome (SIRS), infected pancreatic necrosis, and multi-organ failure. Early stratification of severity is crucial for timely intervention.

Aim and Objective: To evaluate the diagnostic and prognostic significance of serum procalcitonin (PCT) levels in predicting the severity of acute pancreatitis in patients admitted to a tertiary care centre.

Materials and Methods: A case-control study was conducted on 100 patients, including 50 diagnosed cases of acute pancreatitis and 50 healthy controls. Serum procalcitonin levels were measured within 24 hours of hospital admission. The severity of AP was assessed using the Revised Atlanta Classification. Microbiological samples were collected for culture and sensitivity testing. Associations between PCT levels, severity markers, and microbial isolates were analyzed using statistical tools.

Results: In the present study among 50 AP cases, 34% had isolates of Acinetobacter baumannii, followed by E. coli (24%), Klebsiella pneumoniae (22%), and Pseudomonas aeruginosa (20%). Coinfection with A. baumannii and P. aeruginosa was found in 16% of patients. PCT levels were significantly elevated in patients with infected necrosis, systemic complications, and those requiring ICU admission. PCT >0.5 ng/mL was significantly associated with severe AP and multiorgan failure (p<0.05).

Conclusion: Serum procalcitonin is a reliable biomarker for early prediction of AP severity and infection-related complications. It may supplement clinical scores for better risk stratification and management.