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Editor's Correspondence
April 13, 2009

Procalcitonin-Guided Antibiotic Use in Acute Respiratory Tract Infections

Arch Intern Med. 2009;169(7):716. doi:10.1001/archinternmed.2009.27

We read with interest the article published by Briel et al1 in relation to procalcitonin-guided antibiotic use in acute respiratory tract infections. This is a novel idea that will have an impact on decreasing the use of antibiotics. The study was focused on bacterial infection; however, we could not understand why patients with influenza, the common cold, were included, unless they had bacterial superinfection. Was there any serologic evidence of viral infection in the patients with viral infection? As reported previously,2 procalcitonin concentration is elevated in patients with bacterial infection, which, with testing, will help us reduce the use of antibiotics and, in turn, related drug resistance. Is it evident that there is an increase in the relapse of some conditions like bronchitis or chronic obstructive pulmonary disease if the patient is not treated with antibiotics? Moreover, is there a change in the length of time before the next recurrent episode?

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