Procalcitonin assays results did not help emergency department and hospital-based clinicians prescribe fewer antibiotics for patients presenting with suspected lower respiratory tract infection, according to a study published July 19 in the New England Journal of Medicine to coincide with its presentation at the American Thoracic Society 2018 International Conference in San Diego. Procalcitonin is a blood-based peptide that correlates with the severity of bacterial infections. European studies have shown that procalcitonin-based guidance reduced the use of antibiotics with no apparent patient harm. However, in the United States there is no consensus among national authorities and medical societies about procalcitonin-guided antibiotic use for suspected lower respiratory tract infection. The Procalcitonin Antibiotic Consensus Trial included 1,656 patients who presented to the emergency department at 14 U.S. hospitals (primarily urban, academic medical centers from November 2014 through May 2017) with a suspected lower respiratory tract infection. Treating physicians were uncertain whether antibiotic therapy was indicated. Participants were randomized to either the procalcitonin group (n=826), in which the treating clinicians were provided with real-time initial procalcitonin assay results (bioMérieux), or the usual-care group (n=830). Participating clinicians retained autonomy over care decisions, but they received training regarding national antibiotic guidelines for lower respiratory tract […]