The Use of Procalcitonin to Reduce Inappropriate Antibiotic Usage in Respiratory Tract Infections
Posted Oct 05 2009 10:02pm
Serum procalcitonin levels have been shown in the past to be elevated with bacterial infections but not with viral infections. It's important for physicians to be able to distinguish between these two types of infections because antibiotics are often the treatment of choice in the former but ineffective in the latter. Appropriate use of antibiotics can reduce the cost of care and also the likelihood of the emergence of antibiotic-resistant bacterial strains. A recent article revealed some new findings in this area of inquiry (see: Procalcitonin measurement may help reduce antibiotics overuse for lower respiratory tract infections ). Below is an excerpt from the article:
The use of guidelines for treatment of lower respiratory tract infections such as bronchitis and pneumonia determined by measurements of a chemical in the blood known as procalcitonin [PCT] resulted in lower rates of antibiotic use and associated adverse effects, and similar rates of adverse outcomes compared to standard guidelines, according to a study in the September 9 issue of JAMA....[C]linical signs and symptoms are unreliable in distinguishing viral from bacterial LRTI [lower respiratory tract infections], and that as many as 75 percent of patients with LRTI are treated with antibiotics despite the predominantly viral origin of their infection....The researchers found that “the rate of overall adverse outcomes was similar in the PCT and control groups ....The mean [average] duration of antibiotics exposure in the PCT vs. control groups was lower in all patients ...and in the subgroups of patients with community-acquired pneumonia, ..., exacerbation of chronic obstructive pulmonary disease..., and acute bronchitis....Antibiotic-associated adverse effects were less frequent in the PCT group." .... PCT guidance will have substantial clinical and public health implications to reduce antibiotic exposure and associated risks of adverse effects and antibiotic resistance.