Bepaling van procalcitonine om ineffectief antibioticagebruik bij acute luchtweginfecties te verminderen

Procalcitonin levels could help to guide antibiotic therapy for acute respiratory tract infections in primary care. A recently published study has shown that antibiotic prescriptions were reduced substantially by using procalcitonin levels, without harm for the patients. In primary care, however, the effects of antibiotics for acute respiratory tract infections have proven to be minimal. Withholding antibiotics for the whole procalcitonin group would probably have led to the same results. Procalcitonin levels are higher in the case of bacterial infections than viral infections and mere inflammation. Furthermore, the results of previous studies with more severe infections showed the same results as this trial in primary care. In primary care we need a reliable bedside test to differentiate between acute respiratory tract infections of a viral or bacterial origin. The determination of procalcitonin levels could be such a test. However, this needs to be demonstrated in a randomised controlled trial, where randomisation takes place after testing for procalcitonin. To be ethically acceptable, such a study would have to focus on those infections where antibiotics have proven to be of little value.