Volume 20 Issue 4 December 2011
Procalcitonin-guided antibiotic treatment of respiratory tract
infections in a primary care setting: are we there yet?
Pages 360-367
*Rune Aabenhusa, Jens-Ulrik Stæhr Jensenb,c
a
Research Unit for General Practice, University of Copenhagen, Denmark
b
ICU Division, Copenhagen HIV programme (CHIP), University of Copenhagen, Denmark
c
Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
Received 15 February 2011 • Accepted 25 April 2011 • Online 2 August 2011
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.
Cite as: Aabenhus R, Jensen JS. Procalcitonin-guided antibiotic treatment of respiratory tract
infections in a primary care setting: are we there yet? Prim Care Respir J 2011;20(4):360-367. DOI: http://dx.doi.org/10.4104/pcrj.2011.00064
Keywords
Biomarkers, acute respiratory infections, procalcitonin, primary care, diagnostic tests
* Corresponding author. Rune Aabenhus Tel: +45 3532 7171 Fax: +45 3532 7131 Email: runeaa@sund.ku.dk | |
