A blood test may be able to help doctors determine which patients need antibiotics and which do not.
A blood test may be able to help doctors determine which patients need antibiotics and which do not.
Overuse as well as misuse of antibiotics is commonly acknowledged as the main factor driving microbial resistance worldwide.
Antibiotics are most often prescribed for lower respiratory tract infections (LRTIs). LRTIs can mean anything from bronchitis, which is likely to go away on its own, to community-acquired pneumonia (CAP), which can be life-threatening. Up to three-quarters of LRTI patients are treated with antibiotics, even though most of these infections are viral and don't respond to antibiotics. There is some indication that the use of antibiotics has declined in children over the past 12 years.
Swiss researchers randomly assigned almost 1,359 patients with LRTIs who came to emergency at six hospitals to receive antibiotics based on results of Procalcitonin (PCT) test, or based on standard guidelines. It was found that patients in the PCT group were on antibiotics for shorter periods of time: 5.7 days vs. 8.7 days in the control group. The same pattern held true in the subgroups of patients with CAP (7.2 days in the PCT group vs. 10.7 days in the control group); those with chronic obstructive pulmonary disease (2.5 vs. 5.1 days); and those with acute bronchitis (1 day vs. almost 3 days). Fewer people in the PCT group had adverse events (19.8 percent vs. 28.1 percent).
But the researchers emphasised that the blood test has a few hurdles to pass before it can be widely adopted. Most of the patients in the study had pneumonia and many of them had severe pneumonia, a group which often does need antibiotics. Therefore further studies are needed to probe this topic.
Overuse as well as misuse of antibiotics is commonly acknowledged as the main factor driving microbial resistance worldwide.
Antibiotics are most often prescribed for lower respiratory tract infections (LRTIs). LRTIs can mean anything from bronchitis, which is likely to go away on its own, to community-acquired pneumonia (CAP), which can be life-threatening. Up to three-quarters of LRTI patients are treated with antibiotics, even though most of these infections are viral and don't respond to antibiotics. There is some indication that the use of antibiotics has declined in children over the past 12 years.
Swiss researchers randomly assigned almost 1,359 patients with LRTIs who came to emergency at six hospitals to receive antibiotics based on results of Procalcitonin (PCT) test, or based on standard guidelines. It was found that patients in the PCT group were on antibiotics for shorter periods of time: 5.7 days vs. 8.7 days in the control group. The same pattern held true in the subgroups of patients with CAP (7.2 days in the PCT group vs. 10.7 days in the control group); those with chronic obstructive pulmonary disease (2.5 vs. 5.1 days); and those with acute bronchitis (1 day vs. almost 3 days). Fewer people in the PCT group had adverse events (19.8 percent vs. 28.1 percent).
But the researchers emphasised that the blood test has a few hurdles to pass before it can be widely adopted. Most of the patients in the study had pneumonia and many of them had severe pneumonia, a group which often does need antibiotics. Therefore further studies are needed to probe this topic.
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