Patient selection: antibiotics started for a suspected bacterial respiratory infection
Discontinuation of antibiotic therapy should be considered when:
(1) there is no objective evidence of a bacterial pathogen
(2) there is evidence of a viral pathogen
(3) serum procalcitonin concentrations are low
Newer molecular panels can test a respiratory sample across a broad range of pathogens simultaneously, thereby excluding many bacteria and including many viruses at the same time.
Reasons that antibiotic therapy may be continued after there is evidence that it is not needed:
(1) delay in getting the results
(2) delay in acting on the results
(3) doubt about the reliability of the testing
(4) medicolegal concerns
(5) unwillingness to change
