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Acute bronchitis is managed expectantly, and pneumonia is managed with antibiotics. However, accurately distinguishing these conditions, based on history and physical examination alone, is difficult. Although chest x-ray can distinguish acute bronchitis from pneumonia, it is expensive, exposes patients to radiation (often unnecessarily), and is unavailable in some settings. In this European study, investigators determined whether measuring blood C-reactive protein (CRP) and procalcitonin concentrations, in addition to history and physical examination, improved diagnostic accuracy.
Among 2820 adults (mean age, 50) who presented with cough to primary care practices, chest x-ray confirmed pneumonia in 140 patients (5%). The optimum combination …