Procalcitonin to Guide Antibiotic Use in Primary Care

Respiratory tract infections (RTIs) are among the most common reasons for antibiotic prescription in primary care. A test that can differentiate between bacterial and viral RTIs could help to reduce antibiotic use. Procalcitonin (PCT) levels have been used as a marker for bacterial infection in hospitalized patients but have not been evaluated in the primary care setting. In a recent randomized trial, investigators in Switzerland (1 of whom received research support from the maker of the PCT assay used in the study) compared a PCT-guided approach with standard care among adult outpatients who had acute RTIs. All participants were believed — consistent with evidence-based guidelines — to require antibiotic treatment.

When PCT-arm patients had…