Point-of-Care Blood Tests Can Lower Overuse of Antibiotics for Respiratory Complaints

Accurate diagnosis of lower respiratory tract infections is difficult in settings where imaging is not available. Point-of-care tests for serum procalcitonin and C-reactive protein (CRP) — markers for bacterial infection and inflammation, respectively — might assist in excluding pneumonia and preventing overprescription of antibiotics.

Swiss investigators randomized 60 primary care practices (with 469 patients) to manage patients with possible pneumonia (i.e., acute cough plus fever for >4 days, dyspnea, tachypnea, or abnormal focal lung examination) as follows: (1) usual care, (2) antibiotics recommended only if office calcitonin level was >0.25 µg/L, or (3) antibiotics recommended only if office calcitonin level was >0.25 µg/L and evidence…