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Article Type

Original Study

Abstract

Objective The aim of this study is to assess whether procalcitonin (PCT) can distinguish between bacterial and viral lower respiratory tract infections (LRTIs). Background LRTIs are common diseases in children and are common causes of antibiotic prescription, especially in primary care. It is difficult to distinguish viral from bacterial disease because the clinical presentations of LRTIs because of different causative agents may be similar. Inappropriate use of antibiotics contributes toward the development of antibiotic-resistant bacteria, and increases both the length of stay and the costs of hospitalization. Therefore, a routine test that can safely discriminate between viral and bacterial infection is needed. Methods This prospective single study included 45 patients diagnosed clinically with LRTIs (pneumonia and bronchiolitis) and confirmed by radiological laboratory and microbiological investigations and 10 patients as a control group. The participants were categorized into group 1 bacterial infection (pneumonia, 15 patients), group 2 viral infection (bronchiolitis, 30 patients), and group 3 control (10 individuals). Serum PCT levels were determined for the three groups; complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were determined only for group I and group II. Radiological and microbiological investigations were performed for group I and group II. Results Although CRP, ESR, and PCT concentrations were significantly different between patients with bacterial and viral LRTIs, the sensitivity and specificity of PCT were higher. PCT had an area under the curve of 0.995 (95% confidence interval, 0.98-1). Conclusion LRTI is a major health problem. Serum PCT can improve differentiation between patients with a bacterial or viral LRTI compared with CRP and ESR.

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