Time to move on from
"WHEN TO PRESCRIBE ANTIBIOTICS"
"WHEN TO RESIST THE TEMPTATION TO PRESCRIBE ANTIBIOTICS AND BE SAFE FOR THE PATIENT".
In most patients with exception of Septic Shock, we can wait for real evidence of infection and possible source.
ED patients with LRTI and low suspicion of Bacterial Infection, it is reasonably safe to hold ABX if baseline PCT <0.25.
For additional safety, repeat PCT after 6-12 Hours for any rise.
In countries with high baseline antibiotic consumption, it can reduce ABX exposure.
A low PCT value in appropriate clinical context is useful even in ICU patients to safely hold ABX.
Especially so in countries with high exposure to antibiotics.
PCT should not be used to escalate ABX [Jansen J U et al. Crit Care Med. 2011; 39:2048 –58].