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Invited Commentary
October 13, 2008

Procalcitonin-Guided Antibiotic Use vs a Standard Approach for Acute Respiratory Tract Infections in Primary Care

Arch Intern Med. 2008;168(18):2007-2008. doi:10.1001/archinte.168.18.2007

Clinicians treating respiratory tract infections in ambulatory settings must reconcile patients' frequent expectations for prescriptions for antibiotics (whether perceived or actual1) with evidence that antibiotics confer little, if any, benefit for these common and mostly viral syndromes.2,3 Lingering concerns about primary bacterial infection, whether self-limited (eg, Mycoplasma pneumoniae), life-threatening (eg, Neisseria meningiditis4), clinically occult, or an impending bacterial superinfection1 (eg, bacterial sinusitis or pneumonia), also militate against withholding antibiotics. No wonder, then, that the decision to prescribe antibiotics provokes more discomfort among office-based general practitioners than the use of any other class of drugs.5