Case Study

Lower Respiratory Tract Infection (LRTI):
Is it Viral or Bacterial?


Shawn Depcinski
PharmD
Antibiotic Stewardship



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Key Takeaways

Takeaway #1

Takeaway #1

Bacterial co-infection may occur in approximately one-fourth of hospitalized patients with influenza.1



Takeaway #2

Takeaway #2

PCT has a high negative predictive value (NPV) at ≤ 0.25 μg/L, which aids in determining the need for antibiotics in LRTI. When uncertainty exists with an initial negative PCT result, repeating the test within 6 to 24 hours can assist with confirming the initial result, and indicate that antibiotics may no longer be necessary.



Takeaway #3

Takeaway #3

In this case, PCT aided in ruling out bacterial infection, allowing the clinicians to avoid giving unnecessary antibiotics and to continue with the appropriate anti-viral therapy.



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References
  1. Klein EY, Monteforte B, Gupta A, Jiang W, May L, Hsieh YH, et al. The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. Influenza Other Respir Viruses. 2016 Sep;10(5):394-403.