Doesn’t ESR cover everything in terms of diagnosing a bacterial infection? Our doctors say that if ESR is not raised, no infection, the end. Does procalcitonin pick up on infections that do not raise the ESR?

you are right on urgent care/ER providers making PCP look bad by prescribing antibiotics. Plus, and even worse, this reinforces the patient’s expectation of receiving an antibiotics for a URI. This is the exact opposite behavior we are trying to reinforce.

It’s just the same as a parent saying no to candy for their child, the child then throws a tantrum, so what happens… the parent given the child the candy thereby reinforcing the idea that if the child throws a tantrum he will get candy.

I have been practicing for about 5 years and I can think of maybe a handful of cases where I would need to use a test like this. Whatever happened to the waiting for 7-10 days, in the case of sinus infections? Also the AAP as stated that it is acceptable to do watchful waiting for most kids over 2 with otitis. Never mind that 100% of viral conjunctivitis and 50% of bacterial conjunctivitis will resolve spontaneously. We providers have become a bunch of spineless wimps that cave the moment someone breaths loudly.

With that, I’ll go back to watching “House” where everything has an answer…If you haven’t found it, you just haven’t ordered enough tests.

I also find that urgi cares in particular give out z-packs for minimal reasons. No one studies that, just pcps. And this scenario makes pcps look bad: patient gets seen early in week, told it is viral and antibiotics not needed, goes to urgicare later in week and is given an antibiotic. Even the notes don’t make sense: impression is viral uri, plan is z-pack. The patient is left with the impression that the pcp was somehow deficient.