Schuetz et al developed algorithms for guiding antibiotic therapy in various situations using the serum procalcitonin concentration. The authors are from Harvard School of Public Health, Massachusetts General Hospital and McMaster University.
Patient selection: low risk infection in primary care (low acuity, non-pneumonia)
Parameters:
(1) serum procalcitonin concentration in µg/L
(2) clinical status
Antibiotic therapy is appropriate if one or both of the following is present:
(1) serum procalcitonin concentration was >= 0.25 µg/L (strongly recommended if >= 0.5 µg/L)
(2) clinical status shows instability in vital signs, evidence of pneumonia, requires hospitalization, or otherwise high risk
where:
• The features listed for the clinical status would seem to violate the patient selection criteria.
Antibiotic therapy is strongly discouraged if both of the following were present:
(1) the serum procalcitonin level was < 0.1 µg/L
(2) the patient was low risk and stable.
If the patient does not receive antibiotics then the patient is instructed to come back for followup if clinical status is not improving and symptoms have not resolved after 1-2 days.
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