Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

PCT-Guided Antibiotic Therapy in LRTIs

Open Forum Infect Dis; ePub 2018 Dec 3; Townsend, et al

Use of a procalcitonin (PCT)-guided algorithm in patients with lower respiratory tract infection (LRTI) led to a shorter duration on antibiotics without increased adverse outcomes, a recent study found. Researchers conducted a controlled pre-post trial in a US medical center comparing an intervention group of PCT-guided antibiotic therapy to a control group of usual care. The primary endpoint was median antibiotic duration. They found:

  • 174 intervention patients and 200 controls were included.
  • Providers complied with the PCT algorithm in 75% of encounters.
  • PCT-guided therapy reduced median antibiotic duration for pneumonia from 7 days to 6 and acute exacerbation of chronic obstructive pulmonary disease (COPD) from 4 days to 3 days.
  • There was no difference in the rate of adverse outcomes between groups.


Townsend J, Adams V, Galiatsatos P, et al. Procalcitonin-guided antibiotic therapy reduces antibiotic use for lower respiratory tract infections in a US medical center: Results of a clinical trial. [Published online ahead of print December 3, 2018]. Open Forum Infect Dis. doi:10.1093/ofid/ofy327.