Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting: are we there yet?

Rune Aabenhus, Jens Ulrik Stæhr Jensen

    Abstract

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection, could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin concentrations in primary care are low and can be used primarily to rule out serious infection. However, procalcitonin measurement should not be used as the sole basis for clinical decisions; clinical skills are prerequisites for the correct use of this new tool in practice. At present there is no point-of-care test for procalcitonin with acceptable precision, severely hampering its application in primary care. This article reviews the physiology of procalcitonin, describes the assays available for its measurement, evaluates the present evidence from primary care on its use to identify correctly patients who are likely to benefit from antibiotic treatment and to rule out serious infections, and comments on further research to determine a future role for procalcitonin in primary care.
    OriginalsprogEngelsk
    TidsskriftPrimary Care Respiratory Journal
    Vol/bind20
    Udgave nummer4
    Sider (fra-til)360-7
    Antal sider8
    ISSN1471-4418
    DOI
    StatusUdgivet - dec. 2011

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