Abstract: AIM To explore the value of combined serum procalcitonin (PCT) and C-reactive protein (CRP) in treatment of pyrexia after heart failure. METHODS One hundred and sixty-three patients with heart failure were randomly divided into two groups: standard therapy group (n=81) and PCT and CRP-guided group (n=82). Standard therapy group received antibiotics, while PCT and CRP-guided group were treated with antibiotics according to PCT and CRP levels. The rate of antibiotics use, the costs of hospitalization and antibiotics, clinical efficacy, APACHE II score on 14th day, and the length of hospitalization were observed. RESULTS The positive rate of bacteria in patients was 29.8%. Clinical efficacy, APACHE II score on 14th day and the length of hospitalization were similar between the two groups. The rate of antibiotics use and the costs of hospitalization and antibiotics in PCT and CRP-guided groups were lower than those in the standard therapy group. CONCLUSION SPCT combined with CRP reduces the use of antibiotics and costs of hospitalization and antibiotics in treatment of pyrexia after heart failure.