Guidelines
Respiratory Tract Infections

Respiratory Tract Infections

When to Order

Order upon presentation. PCT testing is reasonable to reduce unnecessary antibiotic exposure.

How to Interpret

  • Antibiotic initiation strongly discouraged

  • Alternative diagnosis of viral infection or pulmonary embolism may be considered

  • Consider antibiotic initiation if patient becomes clinically unstable or has strong evidence of bacterial pathogen

  • Antibiotic initiation discouraged

  • Alternative diagnosis of viral infection or pulmonary embolism may be considered

  • Consider antibiotic initiation if patient becomes clinically unstable or has strong evidence of bacterial pathogen

  • Antibiotic initiation encouraged
  • Antibiotic initiation strongly encouraged

How to Follow Up

  • Re-measure PCT is not recommended if patient demonstrates clinical or symptom improvement within 1-2 days
  • If patient has not improved and bacterial is suspected, recheck PCT in 12-48 hours
  • Repeat PCT monitoring at 48-72 hours

  • PCT can be effective every 48-72 hours to reduce duration of antimicrobial therapy in stable patients with concern for respiratory tract infections

  • See "Thresholds for Antibiotic De-Escalation" below

Note

PCT should not be used in place of standard diagnostic tests.

It is a biomarker to aid a clinician in decision making. Algorithm should not circumvent clinical judgement and patient assessment.