Due to overlap of clinical findings and low sensitivity of bacterial diagnostic tests, differentiation between bacterial and viral respiratory tract infections remains challenging, ultimately leading to antibiotic overuse in this population of patients. Addition of procalcitonin, a blood biomarker expressed by epithelial cells in response to bacterial infections, to the clinical assessment leads to a reduction in inappropriate antibiotic initiation. Procalcitonin also provides prognostic information about the resolution of illness, and significant decreases over time are a strong signal for the discontinuation of antibiotics. Current evidence from randomized trials indicates that procalcitonin-guided antibiotic stewardship results in a reduction in antibiotic use and antibiotic side effects, which importantly translates into improved survival of patients with respiratory infections. Inclusion of procalcitonin into antibiotic stewardship algorithms thus improves the diagnostic and therapeutic management of patients presenting with respiratory illnesses and holds great promise to mitigate the global bacterial resistance crisis.

中文翻译：

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使用降钙素治疗呼吸道感染：朝着更加个性化的抗生素治疗决策迈进

由于临床发现的重叠和细菌诊断测试的低敏感性，细菌和病毒性呼吸道感染之间的区分仍然具有挑战性，最终导致该人群中抗生素的过度使用。在临床评估中加上降钙素原（一种上皮细胞对细菌感染作出反应的血液生物标志物），可以减少不适当的抗生素启动。降钙素原还提供了有关疾病解决的预后信息，并且随着时间的推移显着下降是抗生素停用的有力信号。随机试验的最新证据表明，降钙素原指导的抗生素管理可减少抗生素使用和抗生素副作用，重要的是可以提高呼吸道感染患者的生存率。因此，将降钙素纳入抗生素管理算法可改善患有呼吸系统疾病的患者的诊断和治疗管理，并有望缓解全球细菌耐药性危机。