Much has been made of antibiotic overuse, and it’s potential effect on the rise of drug resistant bacteria. Ben Brewer wrote a timely piece today on community-acquired MRSA, which is a symptom of indiscriminate antibiotic prescribing.
Determining whether upper respiratory infections are viral or not has always been a challenge. In today’s practice environment, providers simply prescribe antibiotics to meet both patient expectation and to expedite care. Spending time to counsel patients on the consequences of antibiotic overuse is becoming less feasible.
A recent study in the Archives of Internal Medicine caught my eye, where an objective test can be taken to determine whether upper respiratory infections were bacterial or not. Procalcitonin is an inflammatory marker that rises in cases of bacterial infections. Antibiotic prescription rates were 72 percent lower for doctors who treated patients guided by procalcitonin levels, without a significant change in outcomes.
That’s a significant finding, but there are concerns about cost and delay of results. I would certainly use it if the results were immediate, like a rapid strep test.
Today’s patients are conditioned to favor objective studies, like blood tests and x-rays, over physician opinion. An applicable procalcitonin test can satisfy this need, as well as reduce unnecessary antibiotic use.
A win-win situation for everyone involved.
