Procalcitonin-Guided Antibiotic Use in Lower Respiratory Tract Infection

Abstract This chapter appraises the ProRESP trial, which tested whether a procalcitonin-guided algorithm reduces antibiotic use in patients with lower respiratory tract infections. Researchers conducted a prospective, single-blinded study in Switzerland, assigning 243 patients to either standard care or procalcitonin-guided treatment. Patients in the procalcitonin group reduced antibiotic use by 47% without compromising clinical or laboratory outcomes, while also decreasing treatment duration and costs. Although the chapter mentions study limitations—such as its single-blind design and lack of follow-up procalcitonin levels, the trial demonstrates that an initial procalcitonin levels below 0.25 µg/L can reliably identify patients who do not require antibiotics. Finally, the chapter discusses procalcitonin as an adjunct to clinical judgment and its role in reducing unnecessary antibiotic use.